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健保署這邊 您現在在門前我現在先問比較實際的 在門前有一個評估那你們現在執行的情況是怎麼樣是怎麼樣去授權 還是說有一個共造"},{"start":52.54,"end":59.365,"text":"我們有蠻多的計畫,像全能照顧也有,居家醫療也有當然是用CDR的評估方式來看我簡單跟各位,因為我們重點還是在治療以用藥來說"},{"start":76.957,"end":101.491,"text":"今年我們看去年的資料是大概有14.78萬人有用藥大概花了17.79億元左右所以剛才從很多數字來看現在有一大部分已經是進入長照或什麼的地方從我的醫療來看大概有14.78萬人在治療所以在門診的部分陸陸續續都會有所以這個病人來到門診"},{"start":106.314,"end":113.359,"text":"有一個人在Evaluate,有一個小組,有嘛,還是說你自己臨床醫師,看這個可能怪怪的,再進入這個...遮肘專業再來看所以市長你有說過這樣離人人有嗎?這裡插一個,那裡插一個,長照插一個,這樣不可以有一個..."},{"start":129.915,"end":147.763,"text":"剩一個小組還是什麼,授權給醫院也可以比較中大型醫院,有神經內科,有社工師,有心理師神經內科,這樣合起來,精神科,能夠一個評估不要讓這些病人這樣,因為我自己的媽媽,有年的96歲"},{"start":154.195,"end":182.946,"text":"他就有時候 我就不知道在說什麼啊就他有變那樣的妄想啊 直接說我如果要把他偷竊東西 把他偷竊錢 把他什麼我當然我知道他失職 但是有時候又很清楚啦所以 這種人就很麻煩有時候我早 早行程有時候這樣偷竊問題之後 生活 身體就用了那種人那是麻煩照樣的處理 照樣的處理所以 這種病人"},{"start":183.999,"end":202.541,"text":"所以朝野在那邊講說,看到日本成立這個基本法,大家都想要來設宿舍不宿舍,不過我也想到行政院所講的部分有理,一個正候群要設一個基本法,"},{"start":203.987,"end":231.317,"text":"這遭遇症人就再設一個基本法再設一個基本法 要許我們都要設一個基本法大家都叫行政院的人去找頭就去笑 只要有這個就笑了所以 市長 你的看法是怎樣來 我看你這樣閒閒的沒有啦 我想委員有時候真的就是醫學出身我想非常了解 我想一定的藝術"},{"start":232.837,"end":258.279,"text":"他當然非常非常關心嘛現在重點就是說兩個重點第一個就是說我們現有機制我們是不是可以來強化院長也有說 必要的話我們也可以在院那邊類似像我們當時處理吸肝我們有一個吸肝行政院曾經你也知道有一個辦公室而且我們從2030就提早我們就用這個方式就可以解決一定的意思是這樣當然現在就是說它是一個徵狀"},{"start":260.06,"end":289.039,"text":"你也知道我們那個疾病也有辦法做分類如果每一個疾病都要這樣這個確實就是說我們當然會來來廣聽各界的意見現在就是說最重要的是不是就是說很執行的處理我們現有已經有這個機制是不是不要再跌床架屋現有的機制我剛剛講了散落在各個地方"},{"start":290.18,"end":295.824,"text":"這要整合啦 最大誘因就是你柬埔這裡有支付 評估費用 醫生有診療的費用那這樣做起來才帶勁嘛 如果說這個病人在家庭長照室接下去做後續追蹤 那有問題隨時"},{"start":312.016,"end":320.458,"text":"假藥是有效的,吃那個吃製藥是有效的,所以我們要改進這件事情,這是沒有辦法避免的,因為我們八十幾歲,現在你生日幾%?差不多幾%有,九十歲以上的又比較嚴重,八十歲以上到二十五點一,二十五,八十五,"},{"start":335.929,"end":338.77,"text":"所以這個是無法避免啦你也會失智,我也會失智啦所以誰都有可能遭遇這個問題"},{"start":364.738,"end":365.859,"text":"大家是要正視啦"},{"start":395.379,"end":409.512,"text":"要給他起手、要給他保安檢調單位當然也要受理這如果有一個賤名他就很好很好不要說這個名字不是老高的那種老高起來所以你要有行政院版本出來當然是最好嘛"},{"start":410.376,"end":423.04,"text":"那如果沒有,你現在製草這個要整合,整合是你威脅的事情嘛,因為現在的長照都是你管理的,所以整合起來,製造要讓它,"},{"start":426.681,"end":434.707,"text":"治療、後續、追蹤、follow up,都要到位我現在問你幾個人你都說不清楚包委員我們目前7.99是大概39萬以我們目前各種機制掌握大概70%"},{"start":448.957,"end":461.741,"text":"所以差不多要二、六萬嘛,當然你差的另外一三十萬,我們現在就是剛剛部長馬尾答詢的說你說有在治療的現在有十幾萬嗎?如果治療的話是健保那邊15.78萬多少?15萬,所以你有38萬、40萬的失智病人,你有15萬在治療,還有25萬放在老大手上"},{"start":473.184,"end":494.975,"text":"所以這也是嚴重的所以今天在講這個東西的精神更重要的就是在這裡那你裡面最有力量的就是健保署健保署你在給付的,所以大家都對這個政策你只要到位,大家就跟著政策走好不好來,我問第一題的問題健保署"},{"start":499.132,"end":509.915,"text":"總共 九年四月份生小孩生一萬三千幾個 四萬四千個今年的四月份 存六千個小孩夭壽喔 存一半我問的比較問題的是婦產科這個團隊接生的 照顧新生兒的這小孩減一半這個醫生的收入 這個團隊的收入"},{"start":527.708,"end":542.459,"text":"要不然就算一半,要不然我吃土,要不然我照顧他所以你們現在副總科那邊,你們要怎麼照顧我我不是副總科,我姓董話科,我副總科講話所以你們要一個虛擬的一個總額,譬如說副總科那邊生三十萬的孩子,生二十萬的孩子,生十萬的孩子"},{"start":550.285,"end":568.812,"text":"你那個單價要提高,那醫生幫你找得到嗎?不找也找不到出院醫師跟委員報告,我們最近有跟婦產科學會一些專家有討論會把醫院,就是我們申報部門跟醫院有關比較重症比較難的生產的案例"},{"start":569.502,"end":593.654,"text":"有些會調到100%跟200%先這樣去做那比較一般的大概普遍性的會看我們那個調租標準的預算大概調到25%到50%我們有正視這個問題你不要像東京都一個運貨要生產救護車坐上去這間賣的卡沒有算過一般這間有沒有、那間有沒有、那間有沒有"},{"start":594.634,"end":599.164,"text":"早八點起床,到大九點起床,我們會發生什麼事情呢?打架咧,打架咧,有錢叫打架,沒錢打架"},{"start":606.389,"end":631.342,"text":"現在我們有一些車位是調支援標準這是第一個第一個也是要留一些婦產的專科醫師能夠繼續在醫院服務那比較偏鄉的一些診所他本來是產科的我們想辦法會用其他的方式讓他繼續留在偏鄉那邊服務會用筆算去給他們大概先從這樣去先把原有的人力先固定住你知道屏東現在多炎症嗎"},{"start":632.643,"end":657.758,"text":"屏東現在的婦產科要去要接生的我們的女的婦產科醫師 醫徒暗示要不要在辦所以暗示要先區域聯防屏東市的跟東港的跟邦寮的要用區域聯防我跟妳講去跟邦寮沒辦法有三個醫生去跟鄉村沒辦法有三個醫生要先區域聯防這樣在拖所以他們如果不把這裡顧住這裡如果沒辦法做"},{"start":663.373,"end":684.159,"text":"所以這個屏東的火鈴鈴的case,我想其他縣市也差不多而且醫生到了五、六十歲,你要叫他值班要接生那時候要在那邊等,產婦在那邊等,你醫生也在那邊等所以這個是很折磨、很累所以你們這塊要好用心,不能因為小孩子那麼少,你五、三個跟小女生拚下去不會不會,我們會去就好這個很重要謝謝"},{"start":690.83,"end":691.291,"text":"謝謝蘇星全委的諮詢"}],"gazette":[{"speaker":"蘇委員清泉","start":"2026-05-28T11:05:47.517000+08:00","guessed":false,"end":"2026-05-28T11:05:47.717000+08:00","text":"謝謝主席。","quality":1},{"speaker":"蘇委員清泉","start":"2026-05-28T11:05:48.899000+08:00","guessed":false,"end":"2026-05-28T11:05:54.647000+08:00","text":"請呂建德次長及健保署副署長。","quality":0.846},{"speaker":"主席","start":"2026-05-28T11:05:54.647000+08:00","guessed":false,"end":"2026-05-28T11:05:56.350000+08:00","text":"請呂次長、張副署長。","quality":0.375},{"speaker":"呂次長建德","start":"2026-05-28T11:05:57.872000+08:00","guessed":false,"end":"2026-05-28T11:05:58.012000+08:00","text":"蘇委員好。","quality":0.5},{"speaker":"蘇委員清泉","start":"2026-05-28T11:05:59.254000+08:00","guessed":false,"end":"2026-05-28T11:05:59.535000+08:00","text":"辛苦了。","quality":1},{"speaker":"呂次長建德","start":"2026-05-28T11:06:00.156000+08:00","guessed":false,"end":"2026-05-28T11:06:00.496000+08:00","text":"不敢、不敢。","quality":1},{"speaker":"蘇委員清泉","start":"2026-05-28T11:06:05.114000+08:00","guessed":false,"end":"2026-05-28T11:06:15.729000+08:00","text":"對於失智症，最近因為臺大前院長及前總統馬英九的事，讓大家都嚇到，覺得怎麼會那麼嚴重？","quality":0.632},{"speaker":"蘇委員清泉","start":"2026-05-28T11:06:19.124000+08:00","guessed":false,"end":"2026-05-28T11:06:23.427000+08:00","text":"我請教健保署一個比較實際的問題，你們現在在門診評估與執行情況是怎麼樣？","quality":0.636},{"speaker":"蘇委員清泉","start":"2026-05-28T11:06:23.427000+08:00","guessed":false,"end":"2026-05-28T11:06:23.848000+08:00","text":"又是怎麼授權？","quality":0.833},{"speaker":"蘇委員清泉","start":"2026-05-28T11:06:23.848000+08:00","guessed":false,"end":"2026-05-28T11:06:23.868000+08:00","text":"還是說有共照？","quality":0.667},{"speaker":"蘇委員清泉","start":"2026-05-28T11:06:23.868000+08:00","guessed":true,"end":"2026-05-28T11:06:35.540000+08:00","text":"講清楚一點。","quality":0.2},{"speaker":"張副署長禹斌","start":"2026-05-28T11:06:35.540000+08:00","guessed":false,"end":"2026-05-28T11:06:38.082000+08:00","text":"跟委員報告，我們滿多計畫其實都有含括，像家醫計畫也有，全人照護也有，居家醫療也有。","quality":0.444},{"speaker":"張副署長禹斌","start":"2026-05-28T11:06:38.342000+08:00","guessed":false,"end":"2026-05-28T11:06:40.644000+08:00","text":"當然，我們是用CDR的評估方式來看。","quality":0.875},{"speaker":"張副署長禹斌","start":"2026-05-28T11:06:40.684000+08:00","guessed":false,"end":"2026-05-28T11:06:42.305000+08:00","text":"我簡單向各位委員報告，重點還是在治療。","quality":0.706},{"speaker":"張副署長禹斌","start":"2026-05-28T11:06:42.305000+08:00","guessed":false,"end":"2026-05-28T11:07:09.943000+08:00","text":"以用藥為例，看去年的資料大概有14.78萬人用藥，花了大概17.79億元左右。","quality":0.857},{"speaker":"張副署長禹斌","start":"2026-05-28T11:07:11.524000+08:00","guessed":false,"end":"2026-05-28T11:07:24.131000+08:00","text":"其實從很多數字來看，現在有一大部分已經進入長照或什麼地方；從醫療來看，大概有14.78萬人在治療；至於門診部分，應該陸陸續續都會有。","quality":0.893},{"speaker":"蘇委員清泉","start":"2026-05-28T11:07:24.171000+08:00","guessed":false,"end":"2026-05-28T11:07:32.056000+08:00","text":"所以病人來到門診，會有一個人負責evaluate，還是小組？","quality":0.778},{"speaker":"蘇委員清泉","start":"2026-05-28T11:07:32.977000+08:00","guessed":false,"end":"2026-05-28T11:07:34.978000+08:00","text":"還是臨床醫師看診時覺得怪怪的，再進入……","quality":0.765},{"speaker":"張副署長禹斌","start":"2026-05-28T11:07:35.099000+08:00","guessed":false,"end":"2026-05-28T11:07:35.219000+08:00","text":"就會找專業再來看。","quality":0.625},{"speaker":"蘇委員清泉","start":"2026-05-28T11:07:35.359000+08:00","guessed":false,"end":"2026-05-28T11:07:35.479000+08:00","text":"次長，你有沒有覺得這樣「離離落落」？","quality":0.429},{"speaker":"蘇委員清泉","start":"2026-05-28T11:07:35.659000+08:00","guessed":false,"end":"2026-05-28T11:07:35.939000+08:00","text":"這裡弄一下，那裡弄一下，長照也弄一下。","quality":0.562},{"speaker":"蘇委員清泉","start":"2026-05-28T11:07:35.959000+08:00","guessed":false,"end":"2026-05-28T11:07:56.377000+08:00","text":"可不可以成立一個小組負責，或授權給醫院也可以？","quality":0.714},{"speaker":"蘇委員清泉","start":"2026-05-28T11:07:56.937000+08:00","guessed":false,"end":"2026-05-28T11:08:10.103000+08:00","text":"比如中大型醫院有神經內科、有社工師、有心理師，加上精神科和神經內科合起來做評估，不要讓這些病人像現在這樣？","quality":0.771},{"speaker":"蘇委員清泉","start":"2026-05-28T11:08:10.123000+08:00","guessed":false,"end":"2026-05-28T11:08:19.136000+08:00","text":"我母親96歲，有時候我都不知道他在講什麼！","quality":0.706},{"speaker":"蘇委員清泉","start":"2026-05-28T11:08:20.096000+08:00","guessed":false,"end":"2026-05-28T11:08:23.537000+08:00","text":"他有被害妄想，一下子說外勞偷他東西，一下子偷錢。","quality":0.476},{"speaker":"蘇委員清泉","start":"2026-05-28T11:08:24.298000+08:00","guessed":false,"end":"2026-05-28T11:08:34.521000+08:00","text":"雖然知道他失智，但有時候腦筋又很清楚，讓事情變得很麻煩！","quality":0.64},{"speaker":"蘇委員清泉","start":"2026-05-28T11:08:34.521000+08:00","guessed":false,"end":"2026-05-28T11:08:45.926000+08:00","text":"有的即便腦袋有問題，但身體卻很強壯，這種才麻煩，一下子就跑出去，就是會有這種病人。","quality":0.361},{"speaker":"蘇委員清泉","start":"2026-05-28T11:08:47.700000+08:00","guessed":false,"end":"2026-05-28T11:09:00.835000+08:00","text":"朝野看到日本為此成立基本法，輸人不輸陣，大家也想弄一個，不過我覺得行政院長說的也算部分有理。","quality":0.595},{"speaker":"蘇委員清泉","start":"2026-05-28T11:09:01.216000+08:00","guessed":false,"end":"2026-05-28T11:09:08.228000+08:00","text":"他說一個症候群就要設一個基本法，那麼躁鬱症的是不是就要設一個基本法？","quality":0.375},{"speaker":"蘇委員清泉","start":"2026-05-28T11:09:08.488000+08:00","guessed":false,"end":"2026-05-28T11:09:19.812000+08:00","text":"再來一個什麼病的就再設一個基本法，到時候就會有一、二十個基本法，每一個都要行政院長領銜，光搞這些就瘋了！","quality":0.426},{"speaker":"蘇委員清泉","start":"2026-05-28T11:09:22.653000+08:00","guessed":false,"end":"2026-05-28T11:09:22.993000+08:00","text":"次長的看法為何？","quality":0.571},{"speaker":"蘇委員清泉","start":"2026-05-28T11:09:22.993000+08:00","guessed":true,"end":"2026-05-28T11:09:26.854000+08:00","text":"你看起來有點累累的？","quality":0.222},{"speaker":"呂次長建德","start":"2026-05-28T11:09:26.854000+08:00","guessed":false,"end":"2026-05-28T11:09:26.854000+08:00","text":"不會啦。","quality":0.333},{"speaker":"呂次長建德","start":"2026-05-28T11:09:29.395000+08:00","guessed":false,"end":"2026-05-28T11:09:33.016000+08:00","text":"委員果然是醫學出身的，非常了解狀況。","quality":0.688},{"speaker":"呂次長建德","start":"2026-05-28T11:09:36.097000+08:00","guessed":false,"end":"2026-05-28T11:09:44.084000+08:00","text":"院長當然非常關心，但現在有兩個重點：第一個，是不是先就現有機制來強化？","quality":0.742},{"speaker":"呂次長建德","start":"2026-05-28T11:09:45.205000+08:00","guessed":false,"end":"2026-05-28T11:09:58.216000+08:00","text":"院長也說必要時可以在院那邊，類似當時處理C肝時，你也知道在行政院層級有一個辦公室，而且我們從2030就提早，用這個方式就可以解決，院長的意思是這樣。","quality":0.828},{"speaker":"呂次長建德","start":"2026-05-28T11:09:58.216000+08:00","guessed":false,"end":"2026-05-28T11:10:27.356000+08:00","text":"當然現在它是一個……委員，相信你也知道我們的疾病有一百多種嘛，分類上是這樣，如果每一個疾病都要這樣做，這個確實……就是我們當然會廣聽各界的意見，但現在最重要的是如何去執行及處理，我們現在已經有這個機制，是不是就不要再疊床架屋，我想院長的意思是這樣啦。","quality":0.696},{"speaker":"蘇委員清泉","start":"2026-05-28T11:10:28.977000+08:00","guessed":false,"end":"2026-05-28T11:10:34.021000+08:00","text":"現有的機制，我剛剛講了，它是散落在各個地方，現在應該將它做整合啦。是。","quality":0.667},{"speaker":"蘇委員清泉","start":"2026-05-28T11:10:34.401000+08:00","guessed":false,"end":"2026-05-28T11:10:37.443000+08:00","text":"健保最大的誘因incentive，就是健保這裡有給付評估費用，醫生有診療的費用，這樣做起來才帶勁嘛！對啦。","quality":0.646},{"speaker":"蘇委員清泉","start":"2026-05-28T11:10:37.463000+08:00","guessed":false,"end":"2026-05-28T11:11:02.018000+08:00","text":"如果這個病人是在家庭，然後長照司接下去幫他做後續追蹤，如果有問題時再隨時……其實給藥是有效的，吃失智的藥物是有效的，所以我們可能要花很多錢，這是沒辦法避免的，如果是八十幾歲的人，現在你們算下來差不多占多少百分比，九十歲以上的可能更嚴重嘛。","quality":0.611},{"speaker":"呂次長建德","start":"2026-05-28T11:11:02.158000+08:00","guessed":false,"end":"2026-05-28T11:11:02.358000+08:00","text":"八十歲以上的差不多是25.1%。20.1%？","quality":0.357},{"speaker":"呂次長建德","start":"2026-05-28T11:11:02.358000+08:00","guessed":true,"end":"2026-05-28T11:11:19.329000+08:00","text":"25%，他是隨年齡層，而7.99那是總平均，但是他是跟age、年齡別，當然就是85歲到89歲等等，90歲以上當然是最高，這是跟年齡別的一個……","quality":0.039},{"speaker":"蘇委員清泉","start":"2026-05-28T11:11:19.329000+08:00","guessed":false,"end":"2026-05-28T11:11:48.839000+08:00","text":"這個是無法避免的，你也會失智，我也會失智，你看馬英九都那麼嚴重了，可是他才七十多歲而已，過兩天我可能就……誰都有可能遭遇這個問題，所以大家要去正視。","quality":0.508},{"speaker":"蘇委員清泉","start":"2026-05-28T11:11:48.839000+08:00","guessed":true,"end":"2026-05-28T11:12:08.713500+08:00","text":"如果是現有的患者，健保這邊是不是可以做一個牽頭，你給他創造一個leader，好好去做，不要讓他老化啦，有的病人該治療的就要治療。","quality":0.017},{"speaker":"蘇委員清泉","start":"2026-05-28T11:12:08.713500+08:00","guessed":true,"end":"2026-05-28T11:12:28.588000+08:00","text":"剛剛聽到廖偉翔說失智的病人也沒有幫他診斷，也沒有一個證明，所以他去超商給人家拿東西，或買東西時給人家多拿東西，但卻沒給錢，其實只是小事，但卻執意要給他起訴、要給他報案，報案後檢調單位當然也要受理，假如他有一個證明，那就很好，表示病人沒有被遺漏掉。","quality":0.216},{"speaker":"蘇委員清泉","start":"2026-05-28T11:12:28.588000+08:00","guessed":false,"end":"2026-05-28T11:12:38.177000+08:00","text":"將來如果有行政院版本出來當然是最好，如果沒有，現在這個部分你們至少要去整合。","quality":0.714},{"speaker":"蘇委員清泉","start":"2026-05-28T11:12:39.418000+08:00","guessed":false,"end":"2026-05-28T11:12:54.264000+08:00","text":"整合是衛福部的事情，因為長照這些什麼都是你們在管理，所以你們必須去整合起來，至少要讓他診斷、治療、後續追蹤follow up，通通要到位嘛！沒錯。","quality":0.625},{"speaker":"蘇委員清泉","start":"2026-05-28T11:12:54.264000+08:00","guessed":true,"end":"2026-05-28T11:12:55.645000+08:00","text":"這些病人千萬不要遺漏掉，我現在問你究竟有多少人，你根本說不清楚，這就表示有些人根本就沒有被納入……","quality":0.25},{"speaker":"呂次長建德","start":"2026-05-28T11:12:55.645000+08:00","guessed":false,"end":"2026-05-28T11:13:17.939000+08:00","text":"報告委員，目前如果是7.99的話，大概是39萬，以我們目前現有的各種機制，掌握大概百分之七十，所以差不多是26萬，當然其餘的30萬人，剛剛部長在答詢時有說我們就……","quality":0.594},{"speaker":"蘇委員清泉","start":"2026-05-28T11:13:17.939000+08:00","guessed":false,"end":"2026-05-28T11:13:20.500000+08:00","text":"你說現在有在治療的人是十幾萬人？","quality":0.667},{"speaker":"呂次長建德","start":"2026-05-28T11:13:20.500000+08:00","guessed":false,"end":"2026-05-28T11:13:23.020000+08:00","text":"如果是治療的話，健保那邊……15.78萬。多少？15.78萬。","quality":0.824},{"speaker":"蘇委員清泉","start":"2026-05-28T11:13:23.220000+08:00","guessed":false,"end":"2026-05-28T11:13:24.381000+08:00","text":"15萬，所以全部有38萬、40萬的失智病人，其中15萬人有在治療，那還有25萬人就放任他們四處跑？","quality":0.559},{"speaker":"蘇委員清泉","start":"2026-05-28T11:13:36.384000+08:00","guessed":false,"end":"2026-05-28T11:13:37.465000+08:00","text":"這也是很嚴重的問題。","quality":0.667},{"speaker":"蘇委員清泉","start":"2026-05-28T11:13:39.546000+08:00","guessed":false,"end":"2026-05-28T11:13:56.074000+08:00","text":"因此今天在討論這件事情的時候，更重要的精神就是在這裡，而裡面最有力量的就是健保署，健保署是負責給付的，所以這項政策，你必須要到位，大家才能跟著政策走，好不好？","quality":0.718},{"speaker":"蘇委員清泉","start":"2026-05-28T11:13:56.855000+08:00","guessed":false,"end":"2026-05-28T11:14:10.814000+08:00","text":"再來，我要問第二個問題，健保署昨天說去年4月份一共有一萬三千多個新生兒，1萬4,000個，今年的4月份只剩下6,000個，「么壽」喔，只剩一半耶。","quality":0.547},{"speaker":"蘇委員清泉","start":"2026-05-28T11:14:10.834000+08:00","guessed":false,"end":"2026-05-28T11:14:31.288000+08:00","text":"我要問的問題是，婦產科這個團隊是負責接生、照顧新生兒的，當新生兒減少一半的時候，這些醫生的收入、這些團隊的收入不就只剩一半嗎？","quality":0.702},{"speaker":"蘇委員清泉","start":"2026-05-28T11:14:32.049000+08:00","guessed":false,"end":"2026-05-28T11:14:32.389000+08:00","text":"那不就要去吃土！","quality":0.429},{"speaker":"蘇委員清泉","start":"2026-05-28T11:14:35.632000+08:00","guessed":false,"end":"2026-05-28T11:14:39.414000+08:00","text":"所以有些人就會跑掉，現在婦產科那邊你們要怎麼去照顧？","quality":0.583},{"speaker":"蘇委員清泉","start":"2026-05-28T11:14:39.414000+08:00","guessed":true,"end":"2026-05-28T11:14:41.896000+08:00","text":"我不是婦產科，我是心臟外科，但我要替婦產科說一點話。","quality":0.261},{"speaker":"蘇委員清泉","start":"2026-05-28T11:14:41.896000+08:00","guessed":false,"end":"2026-05-28T11:14:59.507000+08:00","text":"你們要有一個虛擬的總額，譬如婦產科接生30萬個小孩跟接生20萬個小孩，甚至接生10萬個小孩，你那個單價一定要提高，不然那些醫生絕對跑光光，不然也會找不到住院醫師啊。","quality":0.586},{"speaker":"張副署長禹斌","start":"2026-05-28T11:14:59.507000+08:00","guessed":false,"end":"2026-05-28T11:15:26.629000+08:00","text":"跟委員報告，我們最近有跟婦產科學會一些專家討論，會把醫院……就是我們申報的部分跟醫院有關，比較重症的、比較難的生產案例，有些會調到100%跟200%，先這樣去做，比較一般的、普遍性的會看我們那個調支付標準的預算，大概會調25%到50%，我們有正視這個問題。","quality":0.943},{"speaker":"蘇委員清泉","start":"2026-05-28T11:15:26.629000+08:00","guessed":false,"end":"2026-05-28T11:15:40.901000+08:00","text":"你不要像東京都，一個孕婦要生產，救護車坐上去，打去這間醫院問，婦產科沒有人在值班，這間沒有，那間也沒有，再下一間也沒有，跑了8間醫院，直到第9間才送進去，請問我們臺灣會不會發生這種事情？","quality":0.512},{"speaker":"蘇委員清泉","start":"2026-05-28T11:15:40.901000+08:00","guessed":true,"end":"2026-05-28T11:15:49.389000+08:00","text":"東京耶，結果事事都擔心，有錢才是「通驚」，沒錢就變成「逐項驚」。","quality":0.167},{"speaker":"張副署長禹斌","start":"2026-05-28T11:15:49.389000+08:00","guessed":false,"end":"2026-05-28T11:15:57.654000+08:00","text":"現在我們有一些策略是調支付標準，這是第一個，目的也是要留一些婦產的專科醫師能夠繼續在醫院服務。","quality":0.886},{"speaker":"張副署長禹斌","start":"2026-05-28T11:15:57.774000+08:00","guessed":false,"end":"2026-05-28T11:16:12.321000+08:00","text":"比較偏鄉的一些診所，他本來是產科的，我們想辦法用其他的方式，讓他繼續留在偏鄉那邊服務，會用一筆預算去給他們，大概先從這樣去做，把原有的人力先固定住。","quality":0.955},{"speaker":"蘇委員清泉","start":"2026-05-28T11:16:12.641000+08:00","guessed":false,"end":"2026-05-28T11:16:14.342000+08:00","text":"你知道屏東現在多嚴重嗎？","quality":0.818},{"speaker":"蘇委員清泉","start":"2026-05-28T11:16:15.643000+08:00","guessed":false,"end":"2026-05-28T11:16:31.452000+08:00","text":"屏東現在的婦產科，尤其是負責接生的，我們的女婦產科醫師，晚上他們都不願意值班，所以晚上是用區域聯網，屏東市、東港及枋寮必須採取區域聯網。","quality":0.443},{"speaker":"蘇委員清泉","start":"2026-05-28T11:16:31.692000+08:00","guessed":false,"end":"2026-05-28T11:16:50.014000+08:00","text":"我跟你說，去到枋寮沒半個婦產科醫生，去到恆春也沒半個婦產科醫生，我們只好採取區域聯網的方式勉強應對，所以你如果沒有把這些人看顧好，一旦這些醫生都不願意做了，就真的只剩下走路一途了這個是屏東活生生的case，我想其他縣市也差不多。","quality":0.387},{"speaker":"蘇委員清泉","start":"2026-05-28T11:16:50.754000+08:00","guessed":false,"end":"2026-05-28T11:17:06.358000+08:00","text":"而且醫生到了五、六十歲，你叫他值班、要接生，那是要在那邊等耶，產婦在那邊等，醫生也在那邊等，所以這個是很折磨的、很累的，因此這一塊你們要好好用心，不能因為小孩子生的少，你們就棄婦產科跟小兒科於不顧。","quality":0.736},{"speaker":"張副署長禹斌","start":"2026-05-28T11:17:06.778000+08:00","guessed":false,"end":"2026-05-28T11:17:06.878000+08:00","text":"不會、不會，我們會重視。","quality":0.778},{"speaker":"蘇委員清泉","start":"2026-05-28T11:17:06.979000+08:00","guessed":false,"end":"2026-05-28T11:17:07.159000+08:00","text":"這個很重要喔，謝謝。","quality":0.875},{"speaker":"張副署長禹斌","start":"2026-05-28T11:17:07.159000+08:00","guessed":true,"end":"2026-05-28T11:17:10.494500+08:00","text":"好，謝謝委員。","quality":0},{"speaker":"呂次長建德","start":"2026-05-28T11:17:10.494500+08:00","guessed":true,"end":"2026-05-28T11:17:13.830000+08:00","text":"謝謝委員。","quality":0},{"speaker":"主席","start":"2026-05-28T11:17:13.830000+08:00","guessed":false,"end":"2026-05-28T11:17:14.291000+08:00","text":"謝謝蘇清泉委員的質詢。","quality":0.6},{"speaker":"主席（蘇委員清泉代）","start":"2026-05-28T11:17:14.791000+08:00","guessed":true,"end":"2026-05-28T11:17:21.362429+08:00","text":"接續請盧縣一召委員質詢，盧縣一質詢完我們休息10分鐘。","quality":0}]}},"supported_relations":[],"relations":[]}