{"error":false,"id":["154407"],"data":{"IVOD_ID":154407,"IVOD_URL":"https://ivod.ly.gov.tw/Play/Clip/1M/154407","日期":"2024-07-01","會議資料":{"會議代碼":"委員會-11-1-26-23","會議代碼:str":"第11屆第1會期社會福利及衛生環境委員會第23次全體委員會議","屆":11,"會期":1,"會次":23,"臨時會會次":null,"種類":"委員會","委員會代碼":[26],"委員會代碼:str":["社會福利及衛生環境委員會"],"標題":"第11屆第1會期社會福利及衛生環境委員會第23次全體委員會議"},"影片種類":"Clip","開始時間":"2024-07-01T10:38:36+08:00","結束時間":"2024-07-01T10:53:02+08:00","影片長度":"00:14:26","支援功能":["ai-transcript","gazette"],"video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/1f04b26fe05fa65a5d4852edafa849e8fe28e669f0977b51132ad209ccdc257161e0ed21dd71ae2c5ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"蘇清泉","委員發言時間":"10:38:36 - 10:53:02","會議時間":"2024-07-01T09:00:00+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第23次全體委員會議（事由：邀請衛生福利部部長就「有關健保合理支付、保障醫護人員收入、設置百億癌症基金及健康投資等事項」進行專題報告，並備質詢。）","gazette":{"lineno":503,"blocks":[["蘇委員清泉：（10時38分）謝謝主席，我請部長。"],["主席：請邱部長。"],["蘇委員清泉：部長，早上從第一位質詢到我這裡，剛好有一個陳菁徽是醫生，再來是我，等一下就是王正旭。"],["邱部長泰源：是。"],["蘇委員清泉：不是醫療人員的委員比我們更緊張、比我們更緊張。你從早上回答到現在，剛才回答完的那些錢、36%的公務預算，只有那個部分講得比較清楚一點，剩下的我都不知道你在講什麼，空洞無物，我看你繼續當立委好了，你當立委比較適合啦！我跟大家報告，上個禮拜八大醫事團體來拜訪韓國瑜院長還有江啟臣，大家講得非常深入，那是我安排的。我聽江啟臣講的，我聽得很痛心，他說你們去WHA、去瑞士、去日內瓦，我有去過3次，他說你們一直講Taiwan Can Help、Taiwan Can Help，非常的驕傲，我們的健保世界第一名，但是不到一個月變成Taiwan Needs Help、Taiwan Needs Help，因為我們的點滴都搞不定，點滴就是食鹽水、葡萄糖水，什麼輸液？講得那麼有水準，為什麼殺頭的生意有人做，賠本的生意沒人要做？一家永豐出一個紕漏，臺灣居然是停擺！然後永豐就擺爛、擺爛，它到底有沒有在更新設備？有沒有在解決它的缺失？再來的問題就是，你們核價核得那麼低，500CC的核25點，1,000CC的核35點，3,000CC的核65點，比礦泉水還便宜，然後現在要跟人家買，嚇死人了！新加坡那邊500CC的是56塊、73塊，1,000CC的是107塊，3,000CC的是246塊，這樣你買得下去？你也是要買。有問題的進口商你也讓它進，你不要像雞蛋一樣，一個超思，一間40萬營業額的公司進口好幾億的雞蛋，你如果再這樣弄，你會被抓去關呢！部長，你的看法如何？"],["邱部長泰源：我想謝謝委員的指教。"],["蘇委員清泉：我是替你煩惱啦！"],["邱部長泰源：你的擔心，大家都有在打拚，所以目前當然量可以維持衡平，我們找的公司其實都有經過……剛才副署長有說，過去也許有疏忽，但是都已經經過驗證了，絕對每一家……我們是非常小心啦！我們的次長在主持這些相關的工作非常的辛苦，而且他也特別提醒我說，抱歉啦！對於核可的每一間都要給它機會、公平正義，所以現在反而會造成醫院裡面進的廠牌比較多，管理上真的比較麻煩，這個要跟大家道歉啦！"],["蘇委員清泉：一間公司的點滴產量如果超過50%、超過一半，那就有可能會壟斷，有可能會操縱，當然前面給付太低，所以沒有人要做，沒有人要投資，現在這間被養得這麼大，不是每一季的data都要送上來嗎？那個實驗室的data，他們自己檢測的data，你們食藥署都沒在monitor？然後出事了又說，去年就發現它的點滴裡面有pyrogen、有一些雜質，有沒有這回事？你們都沒有在monitor，現在出事了，查廠沒有通過就停產，停產我也會做，讓它停，停一停之後就出事了、出包、開花了。"],["邱部長泰源：我相信食藥署都是按照規定在做事情啦！當然一個配套措施要做考慮，各方面可以再來加強，希望不要發生這種事情，這是我們未來應該要檢討的，而且只有一間獨占，這也是有它的背景啦！因為這間永豐，你很瞭解醫療，它的服務很好啊！它都是送到你的房子裡，服務好，所以醫生、醫療院所就用得比較自然啦！有時候這也是一種競爭之下的產物，但是我覺得站在政府的立場要注意這個問題，這是國安問題啦！未來這部分我們一定會去檢討。"],["蘇委員清泉：我跟大家報告，點滴是很可怕的東西啦！它的重量又重，價錢又便宜，現在卡車把它載到醫院，然後就把它放在走廊那裡，請問誰要來送？它很重欸！"],["邱部長泰源：對。"],["蘇委員清泉：如果要請護士來推，我看馬上就出事了，馬上就有職業傷害了，所以不得已要拜託他們用車幫我們送到病房，每個病房的點滴都放在那裡，因為要叫護理人員一箱一箱的搬，他可能就昏倒了，放一個板子就幾百公斤，所以都叫廠商幫我們送到病房，再加錢給他，錢再加上去就超過你們給付的點數了，所以點滴的部分，現在每間都照健保的核給點數跟你收錢，現在都這樣，現在已經這樣了，如果要再送去樓上，有的會叫你加錢。部長，這種工作有人在做嗎？點滴你核給他們這麼低，他們根本就入不敷出，殺頭的生意有人做，賠本的生意絕對沒有人做，如果你今天把它核到四、五十塊，我看另外那五、六間就擴廠了，這種事情……"],["邱部長泰源：委員，你說得很對，這就是全民要瞭解醫療真的面對很大的困境，所以全民也要來幫忙……"],["蘇委員清泉：你只會砍價格，一直砍、一直砍、一直砍，石崇良最厲害，全部被弄到無路可跑，大家看到石崇良就聞風喪膽。"],["邱部長泰源：他長得這麼老實。"],["蘇委員清泉：沒有啦！讓一個行業混不下去，這個絕對會出紕漏！今天出這個……我不曉得什麼時候會出什麼問題，對不對？所以要全部考量啦！健保每一項的點數，石署長，你當住院醫師的時候，你的點數就是從勞保搬過來的，都亂改，改到現在都亂改一通，要全盤！既然要好好做、既然要釜底抽薪就要好好把點數改一改。"],["邱部長泰源：好。"],["蘇委員清泉：我兒子是心臟外科的醫師，他跟我說接3條血管是幾萬點，我說我去查美國的情況是15倍，所以他就每天都在幹譙，他是做心臟外科的，每次遇到我就每次都在唸，那真的要用騙的，有理想、有抱負、濟死扶傷，我跟你說，現在年輕人都沒有在聽你這一套了，你有可能有、我可能有，現在他們都沒有在聽這一套了，所以我跟大家報告，既然要做要好好做。","第二個，那個百億基金，百億癌症基金是什麼意思？我聽不懂你在說什麼，什麼今年二十幾億、明年六十幾億，那些錢是沒在用嗎？你不用完了……如果照石崇良這種用法，兩個月就花光了，再來呢？那是有在挹注嗎？"],["邱部長泰源：委員是專家啦！我請健保專家跟你報告一下。"],["石署長崇良：跟委員說明，這個百億基金的概念是這樣，就是說它對於有一些還有不確定性，沒有馬上進入健保的癌症新藥，先放在這個基金裡面。"],["蘇委員清泉：是新藥？"],["石署長崇良：對、對、對，癌症的新藥，所以它跟我們的健保總額是切開的，它是一個獨立的公務預算來支應，但是它這個費用還是要控管，所以它的停留時間，我們規劃最長不超過3年，所以用3年來做規劃，在3年內來做評估，一方面可以作為我們健保要納入時的財務衝擊的確實評估，編列相當的預算，避免影響到服務點值，一方面也讓那個臨床試驗沒有做……這些藥大部分都沒有做三期臨床試驗，所以讓它在這兩、三年之間繼續蒐集真實世界資料來做驗證，驗證它的價值，再來做最後的議價。"],["蘇委員清泉：我跟大家報告，美國FDA approved，歐洲也可以用啊！來到臺灣還要再重做，重做到PhaseⅢ，對不對？是不是這樣？還是不用？"],["石署長崇良：沒有，本來有的國家也是像我們，這個制度跟英國學，英國也是有這樣的情形，就是現在的藥物越來越有所謂快速許可的概念，就是unmet medical need，或者是break through，快速核准，所以都還沒完成三期臨床試驗，就先讓它通過藥證。"],["蘇委員清泉：我在香港看他們的衛生署，香港衛生署只要美國跟歐盟有通過，他們就馬上可以用了，不管是藥、不管是特殊材料。"],["石署長崇良：跟委員報告，他們有很高的部分負擔，他們的自負額很高。"],["蘇委員清泉：我們現在新藥進來要五百多天，所以你要用癌症基金來應付這些新進來的要等很久，還是根本負擔不起，這些讓它先用，這些錢有在挹注嗎？你有一直灌水下去嗎？"],["石署長崇良：有。"],["蘇委員清泉：說給你100億，像今年只有二十幾億而已，一下子就用完了。陳昭姿委員跟我說，騙他說有100億，結果只有二十幾億而已，一下子就用完了。這是他講的，所以我現在問你，你有繼續在編嗎？"],["石署長崇良：對，規劃是3年達100億，之後每年都會維持100億。"],["蘇委員清泉：維持100億，是用哪裡的錢？"],["石署長崇良：目前的規劃都是用公務預算。"],["蘇委員清泉：部長，你不要又從健保那裡挪用，枉費他們那樣「舞」。"],["邱部長泰源：我應該不會幹這種事吧！"],["蘇委員清泉：幹這種事你就完了喔！我跟你講。"],["邱部長泰源：健保的費用是維持醫療院所跟照顧人民基本的糧草，如果有什麼額外增加的，希望由國家來幫忙。"],["蘇委員清泉：臺大醫院院長明賢大哥那天也跟我說，他說幸好去年有補一點錢給他，不然他就是50年來首位虧損的臺大醫院院長，他真的要去撞牆、要跳樓了，無言面對，他說還好你補了一點錢給他。所以醫界的滿意度，你看第一張，全世界可能沒有一個公共政策是百姓的滿意度89.7%，將近90%了，結果醫護人員的滿意度只有30%啦！你們還在沾沾自喜，大家都在四處「歕雞胿」，我聽你們在「歕雞胿」，聽了真的很難過。你要做什麼我都會支持，只要他自己能活得下去就好，部長、石署長，我很尊重你，我們大家一起來認真做。","最後，有關癌症篩檢，我跟大家報告，韓國現在的健保費率是6.47%，對不對？好像對吧！6.47%，我們才5.17%，他們的占GDP已經占到八點多了，所以韓國的所有指標都贏我們，平均壽命也贏我們，我們臺灣的平均壽命現在比不上韓國、日本、香港、澳門、新加坡，每一樣都輸，我們的平均壽命已經減少一歲多，現在剩七十九歲多而已。國健署的錢是從哪裡來的？都是像一些菸捐之類的，還是我們再來漲菸捐、菸稅好不好？"],["吳署長昭軍：跟委員報告，我們的錢除了公務預算，就是菸捐來支應，那篩檢的錢目前是用菸捐。"],["蘇委員清泉：我們的癌症只有大腸癌的篩檢高一點點，其他都不及格，你有什麼辦法？剛剛已經有很多人問過了，最後你講這個就好，你有什麼辦法？"],["吳署長昭軍：我想我們如何去提高整體的篩檢率跟涵蓋率，對於早期癌症能否找到是非常重要的……"],["蘇委員清泉：什麼誘因？什麼獎勵？"],["吳署長昭軍：那當然就是要……"],["蘇委員清泉：錢有嗎？錢夠吧！"],["吳署長昭軍：要有經費，我們一直在爭取經費當中。"],["蘇委員清泉：國健署的基金不是很多錢嗎？"],["吳署長昭軍：我們的基金並沒有很多錢。"],["邱部長泰源：我相信這是一定要去做的方向。"],["蘇委員清泉：對啦！好，OK。"],["邱部長泰源：謝謝委員，謝謝！"],["主席：謝謝蘇清泉委員的發言，我們現在先休息10分鐘。","休息（10時53分）","繼續開會（11時3分）"],["主席（王委員正旭代）：我們休息結束，繼續詢答。","下一位請黃秀芳委員。"]],"agenda":{"page_end":118,"meet_id":"委員會-11-1-26-23","speakers":["黃秀芳","陳昭姿","林月琴","陳菁徽","邱鎮軍","王育敏","涂權吉","廖偉翔","蘇清泉","王正旭","鄭天財Sra Kacaw","葉元之","牛煦庭","林淑芬","李彥秀","徐欣瑩","賴士葆","陳瑩","劉建國","楊曜","林憶君","盧縣一","陳冠廷"],"page_start":45,"meetingDate":["2024-07-01"],"gazette_id":"1136801","agenda_lcidc_ids":["1136801_00003"],"meet_name":"立法院第11屆第1會期社會福利及衛生環境委員會第23次全體委員會議紀錄","content":"邀請衛生福利部部長就「有關健保合理支付、保障醫護人員收入、設置百億癌症基金及健康投資\n等事項」進行專題報告，並備質詢","agenda_id":"1136801_00002"}},"transcript":{"pyannote":[{"speaker":"SPEAKER_03","start":8.586593750000002,"end":9.497843750000001},{"speaker":"SPEAKER_03","start":12.113468750000003,"end":13.56471875},{"speaker":"SPEAKER_03","start":20.297843750000002,"end":22.10346875},{"speaker":"SPEAKER_03","start":22.457843750000002,"end":23.402843750000002},{"speaker":"SPEAKER_03","start":28.02659375,"end":28.49909375},{"speaker":"SPEAKER_03","start":29.27534375,"end":34.135343750000004},{"speaker":"SPEAKER_00","start":29.42721875,"end":31.97534375},{"speaker":"SPEAKER_03","start":34.35471875,"end":36.07596875},{"speaker":"SPEAKER_03","start":36.90284375,"end":38.53971875},{"speaker":"SPEAKER_03","start":39.197843750000004,"end":42.18471875},{"speaker":"SPEAKER_03","start":42.72471875,"end":43.80471875},{"speaker":"SPEAKER_03","start":44.49659375,"end":46.555343750000006},{"speaker":"SPEAKER_03","start":47.02784375,"end":55.836593750000006},{"speaker":"SPEAKER_03","start":56.00534375,"end":57.50721875},{"speaker":"SPEAKER_03","start":58.064093750000005,"end":62.65409375},{"speaker":"SPEAKER_00","start":61.101593750000006,"end":61.82721875},{"speaker":"SPEAKER_03","start":64.00409375000001,"end":65.28659375000001},{"speaker":"SPEAKER_03","start":65.57346875,"end":69.35346875},{"speaker":"SPEAKER_03","start":70.21409375,"end":72.94784375},{"speaker":"SPEAKER_03","start":73.38659375,"end":76.55909375},{"speaker":"SPEAKER_03","start":77.92596875000001,"end":83.98409375},{"speaker":"SPEAKER_03","start":84.99659375,"end":88.01721875000001},{"speaker":"SPEAKER_03","start":88.84409375,"end":91.08846875},{"speaker":"SPEAKER_03","start":91.54409375,"end":95.94846875},{"speaker":"SPEAKER_03","start":96.65721875000001,"end":97.87221875},{"speaker":"SPEAKER_03","start":98.51346875,"end":100.03221875000001},{"speaker":"SPEAKER_03","start":100.96034375,"end":102.27659375},{"speaker":"SPEAKER_03","start":103.18784375000001,"end":103.66034375000001},{"speaker":"SPEAKER_03","start":104.11596875000001,"end":105.58409375000001},{"speaker":"SPEAKER_03","start":106.09034375,"end":108.25034375000001},{"speaker":"SPEAKER_03","start":108.75659375000001,"end":109.09409375000001},{"speaker":"SPEAKER_03","start":109.44846875,"end":111.45659375000001},{"speaker":"SPEAKER_03","start":113.12721875000001,"end":113.78534375000001},{"speaker":"SPEAKER_03","start":115.60784375,"end":119.05034375000001},{"speaker":"SPEAKER_03","start":119.53971875,"end":121.96971875000001},{"speaker":"SPEAKER_03","start":122.39159375000001,"end":123.69096875000001},{"speaker":"SPEAKER_03","start":124.50096875000001,"end":125.69909375},{"speaker":"SPEAKER_03","start":126.45846875000001,"end":126.91409375},{"speaker":"SPEAKER_03","start":127.58909375,"end":131.01471875000001},{"speaker":"SPEAKER_03","start":131.47034375,"end":132.26346875000002},{"speaker":"SPEAKER_03","start":133.52909375000002,"end":135.09846875},{"speaker":"SPEAKER_03","start":135.53721875000002,"end":135.79034375},{"speaker":"SPEAKER_03","start":136.16159375,"end":137.35971875},{"speaker":"SPEAKER_03","start":137.98409375,"end":139.48596875},{"speaker":"SPEAKER_03","start":140.48159375,"end":140.90346875},{"speaker":"SPEAKER_03","start":141.51096875000002,"end":143.85659375},{"speaker":"SPEAKER_03","start":145.05471875,"end":147.06284375},{"speaker":"SPEAKER_03","start":147.82221875000002,"end":149.83034375},{"speaker":"SPEAKER_03","start":152.09159375000002,"end":153.22221875},{"speaker":"SPEAKER_03","start":154.04909375,"end":155.28096875},{"speaker":"SPEAKER_03","start":155.78721875000002,"end":156.81659375},{"speaker":"SPEAKER_03","start":158.03159375,"end":159.97221875},{"speaker":"SPEAKER_03","start":160.78221875,"end":162.65534375000001},{"speaker":"SPEAKER_03","start":163.46534375000002,"end":164.52846875},{"speaker":"SPEAKER_03","start":164.96721875,"end":165.96284375000002},{"speaker":"SPEAKER_03","start":167.05971875,"end":168.05534375000002},{"speaker":"SPEAKER_03","start":168.40971875000002,"end":169.27034375000002},{"speaker":"SPEAKER_03","start":170.40096875,"end":171.27846875},{"speaker":"SPEAKER_03","start":171.81846875000002,"end":172.54409375},{"speaker":"SPEAKER_03","start":173.99534375000002,"end":174.46784375000001},{"speaker":"SPEAKER_03","start":175.96971875,"end":177.74159375000002},{"speaker":"SPEAKER_03","start":178.38284375,"end":179.22659375},{"speaker":"SPEAKER_03","start":180.96471875,"end":187.25909375},{"speaker":"SPEAKER_03","start":187.84971875000002,"end":188.47409375},{"speaker":"SPEAKER_03","start":189.06471875000003,"end":191.46096875},{"speaker":"SPEAKER_01","start":192.35534375,"end":192.64221875},{"speaker":"SPEAKER_03","start":195.61221875,"end":196.37159375000002},{"speaker":"SPEAKER_01","start":198.29534375,"end":200.06721875000002},{"speaker":"SPEAKER_01","start":200.52284375000002,"end":202.51409375},{"speaker":"SPEAKER_03","start":202.21034375000002,"end":203.89784375000002},{"speaker":"SPEAKER_01","start":203.23971875,"end":214.02284375000002},{"speaker":"SPEAKER_01","start":214.42784375000002,"end":219.55784375000002},{"speaker":"SPEAKER_01","start":219.91221875000002,"end":233.31096875000003},{"speaker":"SPEAKER_03","start":233.31096875000003,"end":233.61471875},{"speaker":"SPEAKER_01","start":233.61471875,"end":246.60846875000001},{"speaker":"SPEAKER_01","start":246.92909375000002,"end":250.47284375},{"speaker":"SPEAKER_03","start":250.70909375000002,"end":251.01284375000003},{"speaker":"SPEAKER_03","start":251.77221875,"end":253.30784375000002},{"speaker":"SPEAKER_03","start":253.57784375000003,"end":262.16721875},{"speaker":"SPEAKER_03","start":262.80846875000003,"end":267.63471875},{"speaker":"SPEAKER_03","start":268.24221875,"end":270.60471875},{"speaker":"SPEAKER_03","start":271.19534375,"end":271.97159375},{"speaker":"SPEAKER_03","start":272.47784375000003,"end":282.24846875000003},{"speaker":"SPEAKER_03","start":282.88971875000004,"end":289.63971875000004},{"speaker":"SPEAKER_03","start":290.28096875,"end":291.00659375000004},{"speaker":"SPEAKER_03","start":292.86284375,"end":301.43534375},{"speaker":"SPEAKER_03","start":301.99221875,"end":302.97096875},{"speaker":"SPEAKER_01","start":304.50659375000004,"end":326.39346875},{"speaker":"SPEAKER_01","start":327.01784375,"end":335.92784375},{"speaker":"SPEAKER_01","start":336.67034375000003,"end":345.81659375000004},{"speaker":"SPEAKER_03","start":346.13721875000005,"end":351.85784375000003},{"speaker":"SPEAKER_03","start":352.29659375,"end":355.04721875},{"speaker":"SPEAKER_03","start":355.92471875,"end":356.88659375000003},{"speaker":"SPEAKER_03","start":357.62909375000004,"end":360.83534375000005},{"speaker":"SPEAKER_03","start":361.39221875000004,"end":362.60721875},{"speaker":"SPEAKER_01","start":362.42159375,"end":362.67471875},{"speaker":"SPEAKER_03","start":362.67471875,"end":366.08346875},{"speaker":"SPEAKER_03","start":366.43784375,"end":376.96784375000004},{"speaker":"SPEAKER_03","start":377.44034375,"end":378.67221875},{"speaker":"SPEAKER_03","start":379.29659375,"end":380.84909375},{"speaker":"SPEAKER_03","start":381.52409375,"end":382.87409375000004},{"speaker":"SPEAKER_03","start":384.00471875000005,"end":389.53971875},{"speaker":"SPEAKER_03","start":389.99534375,"end":393.82596875},{"speaker":"SPEAKER_03","start":394.07909375,"end":395.39534375000005},{"speaker":"SPEAKER_03","start":395.81721875000005,"end":398.60159375},{"speaker":"SPEAKER_03","start":399.29346875000005,"end":400.93034375},{"speaker":"SPEAKER_03","start":401.43659375000004,"end":402.12846875},{"speaker":"SPEAKER_03","start":402.58409375,"end":405.99284375},{"speaker":"SPEAKER_03","start":406.76909375,"end":407.79846875000004},{"speaker":"SPEAKER_03","start":408.60846875000004,"end":409.36784375},{"speaker":"SPEAKER_00","start":408.74346875000003,"end":408.76034375},{"speaker":"SPEAKER_01","start":408.76034375,"end":409.04721875},{"speaker":"SPEAKER_01","start":409.28346875000005,"end":409.31721875000005},{"speaker":"SPEAKER_01","start":409.36784375,"end":409.73909375000005},{"speaker":"SPEAKER_03","start":409.40159375,"end":409.45221875000004},{"speaker":"SPEAKER_03","start":409.53659375,"end":411.49409375000005},{"speaker":"SPEAKER_03","start":412.11846875000003,"end":422.59784375000004},{"speaker":"SPEAKER_03","start":423.00284375,"end":424.33596875},{"speaker":"SPEAKER_03","start":424.97721875,"end":428.03159375},{"speaker":"SPEAKER_03","start":428.85846875000004,"end":430.03971875},{"speaker":"SPEAKER_01","start":430.27596875,"end":439.69221875000005},{"speaker":"SPEAKER_03","start":438.44346875,"end":445.71659375},{"speaker":"SPEAKER_01","start":440.35034375000004,"end":443.97846875000005},{"speaker":"SPEAKER_01","start":444.58596875,"end":445.24409375000005},{"speaker":"SPEAKER_03","start":446.56034375,"end":448.95659375},{"speaker":"SPEAKER_01","start":449.58096875,"end":450.39096875},{"speaker":"SPEAKER_01","start":450.44159375000004,"end":453.64784375000005},{"speaker":"SPEAKER_03","start":453.39471875000004,"end":454.15409375},{"speaker":"SPEAKER_03","start":454.60971875,"end":463.48596875000004},{"speaker":"SPEAKER_03","start":464.56596875,"end":465.13971875000004},{"speaker":"SPEAKER_03","start":465.29159375,"end":466.97909375},{"speaker":"SPEAKER_03","start":467.45159375000003,"end":471.68721875000006},{"speaker":"SPEAKER_03","start":472.59846875000005,"end":479.33159375},{"speaker":"SPEAKER_03","start":479.85471875,"end":480.47909375},{"speaker":"SPEAKER_03","start":480.95159375000003,"end":487.80284375},{"speaker":"SPEAKER_03","start":488.07284375,"end":490.58721875000003},{"speaker":"SPEAKER_03","start":491.27909375,"end":492.61221875},{"speaker":"SPEAKER_03","start":493.52346875,"end":494.09721875},{"speaker":"SPEAKER_03","start":494.99159375000005,"end":496.98284375000003},{"speaker":"SPEAKER_03","start":497.57346875,"end":500.00346875},{"speaker":"SPEAKER_03","start":502.12971875000005,"end":503.04096875000005},{"speaker":"SPEAKER_03","start":503.14221875000004,"end":503.98596875000004},{"speaker":"SPEAKER_03","start":504.42471875,"end":507.83346875},{"speaker":"SPEAKER_03","start":508.45784375000005,"end":518.90346875},{"speaker":"SPEAKER_01","start":514.53284375,"end":515.07284375},{"speaker":"SPEAKER_01","start":515.7478437500001,"end":515.96721875},{"speaker":"SPEAKER_03","start":518.93721875,"end":529.33221875},{"speaker":"SPEAKER_03","start":529.9228437500001,"end":535.22159375},{"speaker":"SPEAKER_03","start":536.06534375,"end":536.08221875},{"speaker":"SPEAKER_01","start":536.08221875,"end":536.18346875},{"speaker":"SPEAKER_03","start":536.18346875,"end":536.21721875},{"speaker":"SPEAKER_01","start":536.21721875,"end":536.4028437500001},{"speaker":"SPEAKER_03","start":536.4028437500001,"end":537.5334687500001},{"speaker":"SPEAKER_01","start":537.6515937500001,"end":540.97596875},{"speaker":"SPEAKER_02","start":540.97596875,"end":541.2122187500001},{"speaker":"SPEAKER_01","start":541.2122187500001,"end":541.4990937499999},{"speaker":"SPEAKER_02","start":541.9040937500001,"end":602.70471875},{"speaker":"SPEAKER_03","start":554.1553437499999,"end":554.50971875},{"speaker":"SPEAKER_03","start":603.5147187499999,"end":604.66221875},{"speaker":"SPEAKER_03","start":605.1684687500001,"end":606.5690937500001},{"speaker":"SPEAKER_03","start":607.07534375,"end":608.22284375},{"speaker":"SPEAKER_03","start":608.6953437500001,"end":611.00721875},{"speaker":"SPEAKER_03","start":611.74971875,"end":614.63534375},{"speaker":"SPEAKER_03","start":614.9897187500001,"end":615.0234687500001},{"speaker":"SPEAKER_02","start":615.0234687500001,"end":616.76159375},{"speaker":"SPEAKER_02","start":617.2509687500001,"end":638.41221875},{"speaker":"SPEAKER_03","start":636.57284375,"end":646.15784375},{"speaker":"SPEAKER_02","start":645.9553437500001,"end":649.0265937500001},{"speaker":"SPEAKER_03","start":649.0265937500001,"end":665.1084687500002},{"speaker":"SPEAKER_02","start":650.5959687500001,"end":650.64659375},{"speaker":"SPEAKER_03","start":665.83409375,"end":674.2378437500001},{"speaker":"SPEAKER_02","start":667.80846875,"end":668.7703437499999},{"speaker":"SPEAKER_00","start":672.2803437500002,"end":672.75284375},{"speaker":"SPEAKER_03","start":674.7609687500001,"end":679.67159375},{"speaker":"SPEAKER_03","start":679.9753437500001,"end":681.9328437500001},{"speaker":"SPEAKER_03","start":682.5403437500001,"end":683.0634687500001},{"speaker":"SPEAKER_03","start":683.3503437500001,"end":683.97471875},{"speaker":"SPEAKER_02","start":683.97471875,"end":689.5265937500001},{"speaker":"SPEAKER_03","start":689.5265937500001,"end":691.87221875},{"speaker":"SPEAKER_02","start":692.14221875,"end":694.0322187500001},{"speaker":"SPEAKER_03","start":694.0322187500001,"end":699.8034687500001},{"speaker":"SPEAKER_01","start":699.7022187500002,"end":699.73596875},{"speaker":"SPEAKER_01","start":699.75284375,"end":701.7947187500001},{"speaker":"SPEAKER_01","start":701.98034375,"end":705.11909375},{"speaker":"SPEAKER_03","start":702.1828437500001,"end":703.71846875},{"speaker":"SPEAKER_01","start":705.50721875,"end":715.51409375},{"speaker":"SPEAKER_03","start":714.3328437499999,"end":721.7409687500001},{"speaker":"SPEAKER_03","start":722.4834687500002,"end":731.3428437500002},{"speaker":"SPEAKER_03","start":731.6297187499999,"end":734.34659375},{"speaker":"SPEAKER_03","start":734.8528437500001,"end":737.7890937500001},{"speaker":"SPEAKER_03","start":739.6284687500001,"end":743.1384687500001},{"speaker":"SPEAKER_03","start":743.2565937500001,"end":747.13784375},{"speaker":"SPEAKER_03","start":747.6103437500001,"end":750.09096875},{"speaker":"SPEAKER_03","start":751.2553437500001,"end":758.08971875},{"speaker":"SPEAKER_03","start":758.96721875,"end":759.50721875},{"speaker":"SPEAKER_03","start":761.22846875,"end":762.62909375},{"speaker":"SPEAKER_03","start":763.15221875,"end":764.6709687500002},{"speaker":"SPEAKER_03","start":765.31221875,"end":769.4128437500001},{"speaker":"SPEAKER_03","start":771.45471875,"end":774.98159375},{"speaker":"SPEAKER_03","start":775.6397187500002,"end":780.33096875},{"speaker":"SPEAKER_03","start":780.92159375,"end":781.5459687500002},{"speaker":"SPEAKER_03","start":782.3390937500001,"end":783.2334687500002},{"speaker":"SPEAKER_03","start":783.67221875,"end":785.10659375},{"speaker":"SPEAKER_03","start":785.69721875,"end":786.62534375},{"speaker":"SPEAKER_03","start":786.8953437499999,"end":789.15659375},{"speaker":"SPEAKER_03","start":789.5447187500001,"end":790.45596875},{"speaker":"SPEAKER_03","start":791.2153437500001,"end":796.1259687500001},{"speaker":"SPEAKER_03","start":796.3115937500002,"end":798.60659375},{"speaker":"SPEAKER_03","start":798.87659375,"end":806.4365937500002},{"speaker":"SPEAKER_03","start":807.06096875,"end":810.11534375},{"speaker":"SPEAKER_03","start":810.7565937500001,"end":816.91596875},{"speaker":"SPEAKER_00","start":818.4853437500001,"end":825.5559687500001},{"speaker":"SPEAKER_03","start":818.56971875,"end":818.9409687500001},{"speaker":"SPEAKER_03","start":826.19721875,"end":831.0234687500001},{"speaker":"SPEAKER_03","start":831.4453437500001,"end":835.19159375},{"speaker":"SPEAKER_03","start":835.44471875,"end":836.03534375},{"speaker":"SPEAKER_03","start":836.6765937500002,"end":836.69346875},{"speaker":"SPEAKER_00","start":836.69346875,"end":838.11096875},{"speaker":"SPEAKER_00","start":839.0559687500001,"end":847.00409375},{"speaker":"SPEAKER_03","start":843.76409375,"end":844.3715937500001},{"speaker":"SPEAKER_03","start":845.5359687500002,"end":847.0209687500001},{"speaker":"SPEAKER_00","start":847.0209687500001,"end":851.72909375},{"speaker":"SPEAKER_03","start":847.93221875,"end":850.07534375},{"speaker":"SPEAKER_03","start":851.18909375,"end":853.5009687500001},{"speaker":"SPEAKER_00","start":854.46284375,"end":856.9265937500002},{"speaker":"SPEAKER_00","start":857.7703437500002,"end":857.83784375},{"speaker":"SPEAKER_01","start":857.83784375,"end":859.8797187500002},{"speaker":"SPEAKER_03","start":859.8797187500002,"end":859.9809687500001},{"speaker":"SPEAKER_01","start":859.9809687500001,"end":860.0147187500002},{"speaker":"SPEAKER_03","start":860.0147187500002,"end":860.4197187500001},{"speaker":"SPEAKER_01","start":860.20034375,"end":860.5547187500001},{"speaker":"SPEAKER_01","start":861.6684687500001,"end":862.9340937500001},{"speaker":"SPEAKER_03","start":863.42346875,"end":865.27971875}],"whisperx":[{"start":8.592,"end":12.336,"text":"好 謝謝主席 我請部長請邱部長"},{"start":28.052,"end":29.354,"text":"王正旭是"},{"start":39.249,"end":50.252,"text":"不是醫療人員的委員,比我們還要緊張,比我們還要緊張,你再去回答這麼多,剛才剛才回答到哪裡,那裡的錢,36%的公務預算,今天你在說得很清楚而已,昨天我不知道你在說什麼,空洞烏烏啦,我看你繼續做立委好了,你做立委那麼複雜"},{"start":64.096,"end":87.605,"text":"我跟大家報告上個禮拜八大醫事團體來拜訪韓國瑜院長還有江啟臣那大家講得非常深入那是我安排的那我聽江啟臣講的我聽得很痛心他說你們去WHA去瑞士去日內瓦那我有去過三次"},{"start":88.905,"end":111.178,"text":"我跟你們一直講臺灣can help臺灣can help非常的驕傲我們的健保世界第一名但是不到一個月變成臺灣need help臺灣need help因為我們那個點滴都搞不定點滴就是食鹽水葡萄糖水什麼書藝講得那麼有水準為什麼"},{"start":115.672,"end":139.131,"text":"沙頭的生意有人做,培本的生意沒人要做嘛那一個永豐,這樣出一個紕漏,台灣居然是停擺然後永豐就擺爛,擺爛他到底有沒有再更新設備,有沒有再解決他的缺失那再來的問題就是,你人家合價合得這麼兇5百CC的人25點"},{"start":145.24,"end":149.523,"text":"1,000cc的放35點3,000cc的65點皮礦潛水都在秀人家現在要買的怕死人58cc的新加坡的56塊73塊1,000cc的100塊73,000cc的246這要買的下去那也是要買的"},{"start":176.144,"end":179.025,"text":"有問題的進口商,你也要賺,你還像基隆這樣,一個超市這樣40萬的營業額的公司,進口幾十億的基隆,你如果再這樣付,你會被關耶,沒錯嗎?是。你會看什麼?"},{"start":198.648,"end":216.878,"text":"沒有,我想...謝謝委員的指教我是替你歡樂啦你會擔心我們...大家都在打拚所以目前當然...那個量...可以維持這個...很平你說...我們找的公司其實都在...經過剛才副市長有說嘛"},{"start":220.04,"end":220.16,"text":"蘇清泉議員"},{"start":237.322,"end":239.964,"text":"你一間公司的點滴的產量如果超過50%就有可能會壟斷、有可能會超重"},{"start":263.359,"end":290.864,"text":"當然前陣子婦想要嫁,所以沒人要走,沒人要逃出,現在這間讓他娶到這麼大隻,然後你不是每一季都有在data都要送上來嗎?那個實驗室的data,他們自己檢測的data,你們食藥署都沒在monitor,然後又說出事了,去年就發現他的點滴裡面有pyrotin,有一些雜質,有沒有這回事啊?"},{"start":293.424,"end":295.786,"text":"現在出事了,查查沒過都要停場,停場我也要做,停一停就出事了,出包啊,開花啊。"},{"start":304.562,"end":318.854,"text":"我相信食藥署都按照規定去做事情當然配套措施的顆粒後面可以再來加強不要發生這種事情這是應該我們未來要檢討以前只有一間獨佔,這也是有它的背景因為這間永豐你很了解醫療,它的服務很好"},{"start":327.142,"end":341.532,"text":"你都把你送到你的房子要整個合不好所以大家醫生醫療院所就用到比較主人這有時候也是一種競爭之下的產物但是我是覺得站在政府的立場要注意這個問題這是國安問題未來我們這一定會去檢討"},{"start":346.135,"end":359.259,"text":"我跟大家報告喔,這電梯是很可怕的東西啦,抽抽噹噹,抽抽咻咻,現在卡車把你載到你便宜,啊落了,他還要走那裡,要走走走走走走走走走走走走走走走走走走走走走走走走走走走走"},{"start":361.44,"end":376.165,"text":"很痛苦耶!那天索性叫護士來的時候,我說你要出事嗎?你要不要直接傷害啊?所以國府就要拜託他們,用車上去到北邦,每次北邦的車站都放在那裡,因為要叫護理人員,只要一聲一聲的叫他就好了。你也要整個板子,整六百公斤,只有甘有的人我住。"},{"start":386.286,"end":402.905,"text":"所以都叫支付商把我們送到北方,再加錢給他,錢再加起來就超過你們支付的點數了嘛,所以注點的,現在每間也叫健保的合理點數幫你設置,現在都這樣了,如果要再把你送到樓上"},{"start":406.843,"end":424.214,"text":"有的叫你加錢,否定有,這種討論有人在做嘛,啊你那個點滴給人家這麼兇,根本做不出,沙頭的生意有人做,培培的生意絕對沒有人做。如果你今天把它合到,我們有四五十個,我看另外五六間就都擴廠了。"},{"start":429.025,"end":448.745,"text":"這就是我們專門要了解醫療真正面對很大的困境所以專門也要來幫忙大家要在台介紹,在台,在台,在台施宗亮最高,施宗亮最高中國破格遭沒囉大家看到施宗亮文鴻上班"},{"start":451.403,"end":463.227,"text":"沒有啦 這樣一個行業混不下去這個絕對出皮肉我今天出這個 我不知道當時出什麼問題呢 對不對所以要全部考量啦然後那個健保的點每一項的點數齁施主任你做住院醫師的時候你的點數都從老闆過來都亂蓋 現在還在亂蓋"},{"start":479.912,"end":492.416,"text":"全盤,既然要好好的做,既然要福利出身,就好好的都點所該改。我們今天做的行動多好,跟我說接三條會見,我幾萬點,我說我的差異顧客,十五倍。所以他就每天都在趕走,有多好,每天放電話,每天就在喝。那實在是用騙的,有理想有保護,即使扶傷,"},{"start":508.513,"end":526.08,"text":"我現在沒在聽你這套,你可能有,我可能有,現在都沒在聽你這套所以我跟大家報告,既然要好好做第二個,那個百億基金,那百億基金是什麼意思,我聽不懂,我聽不懂你在說什麼什麼今年二十幾個月、六十幾個月,那個錢沒在贏的你沒贏了,如果出動兩種開發,就兩個月就給你開了,還過了"},{"start":536.628,"end":538.693,"text":"委員是專家啦,我請健保的專家幫你報告"},{"start":542.177,"end":566.46,"text":"跟委員說明這個百億基金的概念它是這樣就是說呢它對於有一些還有不確定性沒有馬上進入健保的癌症新藥先放在這個基金裡面新藥是新藥對癌症的新藥所以它跟我們的健保總和是切開它是一個獨立的公務預算來支應但是這個費用還是要控管"},{"start":566.98,"end":580.213,"text":"所以EA停留時間我們規劃是最長不超過三年所以用三年來做規劃那在這個三年內來做評估一方面可以作為我們健保要納入的時候的財務衝擊的確實評估"},{"start":582.295,"end":583.416,"text":"我幫你報告美國FDA批准澳洲的來到台海的點子"},{"start":611.806,"end":612.787,"text":"我去香港看他們的衛生署"},{"start":639.907,"end":657.922,"text":"香港衛生署主要美國跟歐盟有通過,他們就馬上可以用了,不管是藥,不管是特殊材料。跟委員報告,他們有很高的部分負擔,他的支付有很高的。對,我們現在就是我們的新藥要五百多天,所以你要用這個癌症基金來應付這個要新藥的,還要等很久的,或是說健保的負擔不會去的,這要最好讓他先用,所以這要移住嗎?"},{"start":665.885,"end":667.606,"text":"對,現在規劃是3年達100億,之後每年都會維持100億維持100億,那是用哪些錢?"},{"start":692.413,"end":699.418,"text":"目前的規劃都是用公務預算我應該不會幹這種事吧健保的費用是維持醫療院所跟照顧人民基本的糧草"},{"start":714.369,"end":720.873,"text":"臺台議長林賢大哥,臺台議長也會跟我說,他說今年真的要補多少錢,不然一段五十年來,臺台便宜虧損的院長,他真的要去撞牆、跳樓,無緣面對。所以一切的滿意度,你看這一張。"},{"start":739.959,"end":751.725,"text":"我們世界可能沒有一個公共政策說百姓的滿意度89.7,要90%啦!結果醫護人員的滿意度都30%啦!這樣你來沾沾自喜,大家四個在噴雞骨,我聽你們在噴雞骨,我聽到很恐怖的!那所以,你要做什麼我都給你支持,只要他給我,我就得啦!"},{"start":765.336,"end":775.844,"text":"好 部長 署長 署長 我很羨慕你的尊重我們大家做的很精彩 為什麼 癌症篩檢我跟大家報告 韓國他現在的健保匯率是6.47 對不對好像對吧 6.47 我們才5.17他們的佔GDP已經佔到7 8點多了"},{"start":791.303,"end":809.591,"text":"所以韓國的所有指標都贏我們啊,平均壽命也贏我們啊我們台灣的平均壽命現在比不上韓國、日本、香港、澳門、新加坡哇,大行都輸,我們的平均壽命已經減10倍,現在剩70多倍而已這樣國建署你的錢是要再來的,你的錢如果要給健保還是要有什麼冤姦什麼的,我們再來起冤姦,再來起冤稅好不好"},{"start":818.553,"end":825.164,"text":"我們的錢大概跟委員報告,除了公務預算就是菸金來支援,那篩檢的錢目前是用菸金"},{"start":826.243,"end":846.476,"text":"阿我們的只有大長海篩檢力高一點點其他都不及格阿有什麼補?他們剛才有很多人問阿想不想講這個就好了你有什麼我想我們如何去提高整體的篩檢力跟涵蓋力對於早期癌症病毒是非常重要的我們幼兒園怎麼獎勵阿錢有嗎?錢夠嗎?國健所基金不是很多錢嗎?"},{"start":854.445,"end":854.525,"text":"蘇清泉委員"}]}},"supported_relations":[],"relations":[]}