{"error":false,"id":["152177"],"data":{"IVOD_ID":152177,"IVOD_URL":"https://ivod.ly.gov.tw/Play/Clip/1M/152177","日期":"2024-05-06","影片種類":"Clip","開始時間":"2024-05-06T09:31:04+08:00","結束時間":"2024-05-06T09:37:15+08:00","影片長度":"00:06:11","支援功能":["ai-transcript"],"video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/6319d5f220c85a68cd2686a0b7bf6e41310b11d8215eda9ed65503e05c7869ecc78416d463be3f225ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"陳昭姿","委員發言時間":"09:31:04 - 09:37:15","會議時間":"2024-05-06T09:00:00+08:00","會議名稱":"立法院第11屆第1會期社會福利及衛生環境委員會（事由：舉行「全民健康保險醫療給付費用總額之現況與展望」公聽會）","transcript":{"pyannote":[{"speaker":"SPEAKER_00","start":1.0603437500000001,"end":15.84284375},{"speaker":"SPEAKER_00","start":15.94409375,"end":51.752843750000004},{"speaker":"SPEAKER_00","start":52.12409375,"end":56.275343750000005},{"speaker":"SPEAKER_00","start":56.44409375,"end":74.50034375},{"speaker":"SPEAKER_00","start":74.53409375000001,"end":76.66034375000001},{"speaker":"SPEAKER_00","start":76.94721875,"end":80.81159375},{"speaker":"SPEAKER_00","start":80.99721875,"end":94.54784375000001},{"speaker":"SPEAKER_00","start":94.61534375000001,"end":127.70721875000001},{"speaker":"SPEAKER_00","start":127.77471875,"end":141.91596875000002},{"speaker":"SPEAKER_00","start":142.25346875,"end":150.13409375},{"speaker":"SPEAKER_00","start":150.37034375000002,"end":165.50721875000002},{"speaker":"SPEAKER_00","start":165.89534375000002,"end":194.80221875},{"speaker":"SPEAKER_00","start":194.97096875000003,"end":206.44596875000002},{"speaker":"SPEAKER_00","start":206.93534375000002,"end":214.61346875},{"speaker":"SPEAKER_00","start":215.00159375,"end":234.72846875000002},{"speaker":"SPEAKER_00","start":235.23471875,"end":237.91784375},{"speaker":"SPEAKER_00","start":238.28909375,"end":239.01471875000001},{"speaker":"SPEAKER_00","start":239.43659375000001,"end":248.14409375000002},{"speaker":"SPEAKER_00","start":248.97096875000003,"end":253.76346875000002},{"speaker":"SPEAKER_00","start":254.08409375000002,"end":275.76846875},{"speaker":"SPEAKER_00","start":276.00471875,"end":278.77221875000004},{"speaker":"SPEAKER_00","start":279.10971875,"end":308.03346875},{"speaker":"SPEAKER_00","start":308.79284375000003,"end":327.74346875000003},{"speaker":"SPEAKER_00","start":327.84471875,"end":333.54846875000004},{"speaker":"SPEAKER_00","start":333.83534375000005,"end":337.66596875000005},{"speaker":"SPEAKER_00","start":339.35346875000005,"end":346.15409375},{"speaker":"SPEAKER_00","start":347.40284375000005,"end":367.97346875000005},{"speaker":"SPEAKER_00","start":369.13784375,"end":370.97721875}],"whisperx":[{"start":1.304,"end":29.892,"text":"主席、各位委員及專家代表那2020年總統大選三黨的候選人都對於一個提高臺灣的健康投資有共同的共識那本黨也是支持這個點質要有一定的保障但是由政府來撥補畢竟不是長久之計因為沒有辦法確定這個財源是穩定的那健保第一個十年我覺得是全民皆大歡喜民眾跟這個醫療大家都滿意度很高那第二個十年其實開始面臨一些財務的挑戰"},{"start":31.072,"end":31.112,"text":"陳昭姿議員"},{"start":52.202,"end":52.322,"text":"陳昭姿議員"},{"start":77.805,"end":79.527,"text":"財務困窮越來越大我現在會用這兩句話來形容臺灣的健保小病保得好"},{"start":94.781,"end":109.511,"text":"大病有缺口這是我們要的健保嗎這符合社會保險的精神嗎因此在提高健保的同時健保點植的同時我們主張有幾個配套措施一方面避免因為論量濟酬帶來的無可避免的衝量行為那一方面也是說因為論量濟酬很難免的有時候會有服用濫用的這些事實"},{"start":119.918,"end":140.516,"text":"那再來就是健保的支付架構如果不改善的話比如包括納入醫療品質的這個衡量這樣做法才是讓整個健保永續而且成為臺灣真正護國神山的保障因此在提高健保點值的同時我們主張有幾點配套措施第一個消除因為專業服務不足"},{"start":142.278,"end":143.119,"text":"中文字幕提供"},{"start":165.999,"end":168.581,"text":"整體醫療機構大概只佔GDP的5.5的健保因為它未能及時去對應人口結構的急劇的改變造成醫院普遍的要仰賴這個要價差來做一部分的彌補那當點值提高的時候我們要同時處理"},{"start":187.654,"end":187.974,"text":"陳昭姿"},{"start":207.003,"end":232.995,"text":"第三點就是只需要要依法退出健保給付為了幫助整個醫療資源能夠有效的運用跟合理的分配那落實醫療分級刻不容緩那除了各級醫院的分工之外請記得要將社區藥局納入分療一級體系全世界早就推行了三四十年的這個自我照護那但是從未落實在台灣我們應該鼓勵小病症交由社區藥局藥師來照顧"},{"start":235.636,"end":236.277,"text":"委員．陳昭姿"},{"start":254.187,"end":278.058,"text":"一旦退場會逐漸改變人民的這個就醫行為會到社區去購買根據健保署的評估只要每人每年每一個人一次就醫我們就可以省下375億點值這個最後的影響會非常的深遠那為了恢復台灣的醫療而且我們曾經是明月前茅的一個榮景但是現在不是了現在包括這個"},{"start":279.198,"end":302.393,"text":"平均餘密然後這個癌症存活率等等新症候選等等都在OECD國家全盤接輸這不是人才問題而是資源的這個問題所以我們建議要健保支付要納入有關品質的進步方案例如已經做一半卡住的DRG還有這所謂的論值計酬Pay for performance然後以結果以治療的結果為導向的包括幾副Occam based bundle payment"},{"start":308.857,"end":337.359,"text":"我覺得健保署應該用獎勵的方式來鼓勵各個醫療機構提出更可行而且可受公平的透明化的醫療品質方案我們用品質來爭取合理的給付這個是在我們把點值提高的這個論量計的方式說一個很重要的配套措施好那麼結論是本黨還有我個人都非常支持醫療點值要受到保障但是我們也要求有以下的配套措施其中有4點第一個"},{"start":339.4,"end":339.54,"text":"主席主席"},{"start":369.195,"end":369.56,"text":"陳昭姿委員"}]}},"supported_relations":[],"relations":[]}