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就是說在 當然最近那個美國有宣布他是對這個專利期內的藥跟其原料藥才課稅所以其他的這個學名藥的原料藥還有學名藥那麼到美國還是沒有關稅啦"},{"start":76.994,"end":98.47,"text":"阿川普是公算的,我是要撒謊的阿我們現在的原料藥,台灣也有幾個藥廠在做原料藥阿因為成本很高阿因為我們偉大的施護長跟健保署我們沒有供應到美國的專利藥的原料藥所以對我們沒有影響阿如果是學名藥的原料藥?也沒有課稅"},{"start":99.511,"end":120.041,"text":"那他現在要扣是扣專利藥就是那個新藥啦專利藥集齊原料藥集齊原料藥所以我們台灣沒有在做這個專利藥輸美的只有一個啊這個藥廠已經在美國也要設廠了所以也不受影響所以他在說什麼跟我們沒有關係沒有關係沒有影響好那第二個問題我們"},{"start":127.372,"end":135.821,"text":"最近我們部長有講說因為我們的原料藥大部分都來自印度跟中國大陸對不對原料藥嘛對全球都這樣日本、韓國、台灣是要做一個料"},{"start":140.795,"end":168.042,"text":"聯盟來自己來開發這行得通嗎應該這麼說就是各國現在也都重視到這個多元分散那個原料要來源所以我們也有一個叫做這個國家藥品韌性整備計畫裡面就打算要來鼓勵在台灣開發原料要但是我們也不可能全部的原料要都自己做因為這個是一個高汙染的產業那也沒那麼多"},{"start":169.122,"end":197.008,"text":"所以需要跟其他的友好國家大家建立這個非紅供應鏈所以大概有這樣的構思在努力因為顏料最原始的顏料就是礦區出來然後再去墮碎然後再去分提煉分解那個一定是要國家很大眾生夠因為那是污染還會有時候要爆炸所以"},{"start":198.459,"end":221.436,"text":"一定是那種澳洲、中國大陸、印度這種大國才有辦法我們這裡只能看中間的原料藥的後面那一段我們也有原料藥廠,我們有幾家原料藥廠再來因為時間有限,我不想像王毅民這樣講那麼久第二個問題"},{"start":224.227,"end":238.999,"text":"馬鈴薯因為現在所有的館長大家都很歡樂的馬鈴薯以前是如果化解我們小時候在健康期就知道化解後它會臭香臭香裡面一定有一些化學藥物品"},{"start":239.793,"end":248.418,"text":"那這個叫做ソラリン嘛 它會閃成ソラリン那ソラリン怎麼會翻成龍奎簡這個是誰翻的啊 哪一個天才啊我們這些外來語到底就是喪在翻裂的啊你看日本的外來語是都很有藝術的我們這個ソラリン 這個是什麼東東啊叫做龍奎簡 這是石耀書 江志剛你發明的喔"},{"start":269.827,"end":283.18,"text":"好那這種以前是整批退現在美國要求我們要廠子裡面拿回去然後自己分 把餐廳吃掉就可以做洋芋片 什麼這樣做"},{"start":287.181,"end":314.868,"text":"我們是這樣第一個要先強化這個源頭管理所以在這個美國他在那邊要出口之前他就要去強化檢疫規定包含要噴灑這個叫做那個發芽劑那個發芽的抑制劑他要噴灑然後要去通過我們這個房檢署相關的這個檢疫規定所以說完成OK了之後他才可以上傳"},{"start":316.108,"end":342.43,"text":"那因為如果在這個傳運過程當中有發生這個腐爛的情形的話當然如果你整批太高的比例還是會退運的那如果只是部分的話那它就經過特殊的封裝處理到加工地點再去做剔除啦 是這樣因為我們屏東黃山齁 它仿良那邊的芒果要銷日本那芒果的皮不薄而已啊"},{"start":343.243,"end":359.597,"text":"如果那些藥丟兩下去,就一點點黑掉所以就要烘過,燻煙燻,可能部長也不知道以後有機會帶你去看看啦有的是用那五十五度的水把它燙過,這樣它那兩下去會死去如果不去跟日本,如果有電工,能補出來日本是整個在消費"},{"start":368.064,"end":385.943,"text":"整批的 整貨物就給你銷毀所以沒有地銷的所以你們在把關 你們在把關要 要 要 要 嚴格 不能這樣他美國講什麼 你做什麼不會 因為他進到台灣之後加工處理的這個地點也是要我們許可的"},{"start":386.443,"end":398.999,"text":"所以它的那個加工那個食品加工的那個許可再製的話我們會特別的去強化管理因為這個跟進鏈它如果發芽之後產生那個收納率這個"},{"start":401.383,"end":423.444,"text":"成年人吃了 其實老闆娘嘛 欸 孩子啊 血抽筋欸你神經系統受不了欸 有的翹起來欸所以你做醫 我們都醫生 你就要把關耳神欸不要發生命案 那時候你也受不了囉那第二個就是剛剛有講基改的食品不能進校園 因為現在"},{"start":425.519,"end":446.644,"text":"現在的國中國小現在的營養午餐現在各縣市好像都承諾要免費由政府來支出台北市一餐是75塊我們屏東市57塊我們屏東比較小一點就對了好這些基改的這個食品你剛剛有承諾說不會進嗎不會進校園嗎不會喔那有入華的嗎有入華的嗎對學校衛生法"},{"start":453.689,"end":477.861,"text":"有嘛對 剛剛委員也知道那再來就是含萊克多巴胺的也不能進校園 現在沒有進校園沒有 現在是百分之百用國產豬那這個不要再讓他們進到校園去是的 四年來百分之百百分之百這個很重要 這個不能開玩笑的所以這三樣都要很小心好 來 再來黃田署站起來"},{"start":484.366,"end":512.139,"text":"我們現在的動物用藥跟人的要流用是在我第八屆的時候那個時候部長你現在做醫事司長那個時辰在這裡就在這裡檢討幾行幾行要讓人 人可以養 那些動物可以養我們現在的動物用藥全台灣起 從娘到起到我的毛小孩總共兩百八十幾萬隻 要到三百萬隻三百四"},{"start":516.261,"end":527.566,"text":"所以現在照顧毛小孩的這些年輕人,他們把它當作是家人所以我們健保的可能不是2300萬人,是要2670萬人"},{"start":532.828,"end":557.648,"text":"這樣可以同意嗎這30%是動物用藥 70%都是流用的那現在開放到剛剛講是200多種了是不是現在要開放的話都701項還會再增加我要替這些毛小孩的事主講講話因為"},{"start":560.542,"end":576.061,"text":"簡報是因為石崇洋部長跟健保署強砍一直砍一直壓所以健保的藥價都很合理很低所以大家都這樣犀利現在豆腐用藥進木前時"},{"start":583.342,"end":597.45,"text":"我們醫師是涵蓋中醫、西醫、亞醫那獸醫是農業不發的證照所以獸醫開出來的處方是獸醫師自己調劑、自己給藥、自己收費沒有藥師嘛"},{"start":599.591,"end":617.931,"text":"要是沒有介入嘛,那你現在這些毛小孩的素質,他們的負擔太大嘛,我覺得他們的業務太貴嘛,他們如果像健保這樣搶的,應該很合理的啦,所以現在的問題是出於錢的問題嘛,你一直貴,"},{"start":621.355,"end":641.173,"text":"吸血管用藥 癌症用藥 這些訴訟怎麼負擔得起呢那你現在是想把這些獸醫師開處方因為他的獸醫的診所什麼也好他沒有辦法備那麼多種藥嘛所以他都處方幾個月叫他去藥局尿嘛藥局尿大家都睜一隻眼閉一隻眼嘛所以有時候"},{"start":648.787,"end":661.162,"text":"藥局來跟便宜調約說要給動物用的,我都搞不清楚你現在是怎樣規範所以主席今天提這個題目非常好至少要把它釐清嘛,我認為"},{"start":663.22,"end":679.825,"text":"對 完全 這個委員講的我完全同意啦就是在這個動物的這個治療上面是沒有醫藥分業它就是由這個獸醫師直接就可以提供藥物啦那只不過是因為現在它用到了人用藥"},{"start":680.805,"end":709.528,"text":"那人用藥基於我們是主管機關的立場必須要掌握流向啦那麼一方面也要注意到這些用藥的安全包含不要因為濫用造成抗藥性的問題這個會回過頭來危害到人體健康跟我們未來使用藥物的選擇那另外也有一些比較高風險的藥物的管理像麻醉的用藥啦這些鎮定安眠的用藥那麼也避免人跟動物之間"},{"start":710.709,"end":734.084,"text":"然後老來老去,不知道怎麼回到去啊所以上次我們這個過去健保管得這麼好所以這個是不希望有這個藥品管理的漏洞啦把這一塊納到健保署來管理可以啊可以嗎食藥署來管理啊我真的很擔心,因為我是臨床醫師我是心臟科醫師你是急診科,你腎臟科"},{"start":740.519,"end":747.391,"text":"麻醉的藥FG的藥這些東西是很可怕的如果流用出來"},{"start":749.114,"end":773.203,"text":"報告委員 一支藥品每一顆都歷歷皆清楚 流向絕對掌握的這個我們都要把它管控得很好啦 就是要管控得很好所以我們現在也在跟農業部跟他合作嘛 就讓我們兩邊的這個系統可以解決一方面這個藥商供藥的流向在哪裡 然後使用的量如何"},{"start":774.123,"end":786.032,"text":"這樣我們才能夠供給確保這個不管是動物要用藥還是要人用藥都能夠穩定供應人的用藥的劑量是跟狼犬一樣這個是我念到的啦我們今天要記"},{"start":788.001,"end":813.001,"text":"所以這個動物用藥跟人的用藥會不會流用我比較擔心的是一些管制藥品跟麻酸藥品這個真的會出事而且現在的量那麼大而且不要讓這些迅速負擔太大因為我們到獸醫店去獸醫師那邊去我覺得都很貴那個動物小旅館都要一天多少錢多少錢比健保還貴"},{"start":814.082,"end":838.664,"text":"你知道嗎?所以健保局實際上就是夭壽的所以這一塊一定要好好的管理那你要要嘛就他們開處方簽全部都到健保要求去領藥至少藥師也可以管制一下雖然那事不上這些藥師也去受一些這些的訓練讓他們有本質血能能增加"},{"start":839.545,"end":867.304,"text":"不然的話那我們的藥師這一塊也是沒有沒有所以我們現在初步的規劃方向也是雙軌制啦一方面是可以常用備藥的話可以從藥商或藥局直接供應或者是因為不是常備的部分備不足的部分可以到藥局因為比較方便也可以去拿所以是朝向用雙軌制的方式來重新規劃這樣"},{"start":869.305,"end":888.292,"text":"杜署長我要講,現在我們的健保藥局,如果我看不到很多行,他們會去物流那裡調,調了再栽培過來,然後藥是再發給我們的病人,那這樣是很上軌道的,那你健保藥局如果你"},{"start":889.272,"end":918.075,"text":"你那個獸醫師不可能看那麼多藥嘛他比較有可能他就把燉藥就倒了所以一定拿來藥取 健保藥取這樣釀啊健保藥取這樣阿婆管制阿婆這方面的知識啊一些管制藥 一些麻醉藥那個甚至會出問題然後你們的對獸醫師的管理有那麼嚴格嘛然後他自己開除方 自己調藥 自己配藥然後自己藥藥藥品的副作用 交叉反應那個會不會過量 會不會死掉"},{"start":919.011,"end":940.994,"text":"那個都是因為現在養寵物的人那麼多所以今天沒時間講到經濟動物那個更大一塊但是這些寵物毛小孩這邊很多年輕人這樣我們是要很小心那獸醫師這邊怎麼管理現在獸醫師有幾個目前全台灣的獸醫師大概有6000多位"},{"start":941.334,"end":956.658,"text":"六千多,那跟中醫是差不多啦那有兩千多家的動物醫院,就是獸醫的診療機構,就是動物醫院所以這一塊,暫緩實施,我也不知道是在暫緩實施什麼,是現在這樣繼續?這樣繼續這樣?我皮膚這樣齁?沒中?你是你最高的,你要講話呢?我先..."},{"start":966.511,"end":983.706,"text":"應該是說我們要在最短的時間內重新檢討那個辦法因為那個辦法裡面它涉及到要如何成為這個保護用藥動物保護用藥的程序相關的規定還有使用上的規定要趕快重新檢視我們會盡快的時間內去訂出新的辦法"},{"start":988.97,"end":1007.157,"text":"獸醫師、藥師還要管理辦法還有藥品還有一些危險藥品高菌性藥品都要好好的管理好 署長你跟衛生部的愛好啊 感到和諧是 報告委員就是因為原來的辦法裡面有一些可能沒有規定的細節上會"},{"start":1010.239,"end":1035.13,"text":"沒有辦法也符合到現在目前的一個期待啦所以說我們現在要收回這個辦法的時候都會將社會各界的意見包括雙方相關利害關係人還有我們兩個單位的意見我想大家都會做一個綜合考慮那以及解決到我們現在的寵物就是我們的犬貓跟非激進動物牠們的生命權跟醫療權的保障之下往這個更完善的制度方向來進行以上 謝謝"},{"start":1037.251,"end":1039.073,"text":"時代不一樣啦,我們要面對問題解決問題啦,加油,謝謝"}]}},"supported_relations":[],"relations":[]}