{"error":false,"id":["170227"],"data":{"IVOD_ID":170227,"IVOD_URL":"https://ivod.ly.gov.tw/Play/Clip/1M/170227","日期":"2026-07-01","會議資料":{"會議代碼":"委員會-11-5-20-20","會議代碼:str":"第11屆第5會期財政委員會第20次全體委員會議","屆":11,"會期":5,"會次":20,"臨時會會次":null,"種類":"委員會","委員會代碼":[20],"委員會代碼:str":["財政委員會"],"標題":"第11屆第5會期財政委員會第20次全體委員會議"},"影片種類":"Clip","開始時間":"2026-07-01T11:14:11+08:00","結束時間":"2026-07-01T11:24:29+08:00","影片長度":"00:10:18","支援功能":["ai-transcript"],"video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/10566d69eaf1b9ac973036208a2d69abca9306fd69d22fc010bb06545781b11b303090bacd9a8aae5ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"陳玉珍","委員發言時間":"11:14:11 - 11:24:29","會議時間":"2026-07-01T09:00:00+08:00","會議名稱":"立法院第11屆第5會期財政委員會第20次全體委員會議（事由：一、彙總整理提出「中華民國115年度中央政府總預算案審查總報告（公務預算部分）草案」提報院會案。\n二、彙總整理提出「中華民國115年度中央政府總預算案附屬單位預算營業及非營業部分審查總報告草案」提報院會案。\n三、審查本院委員吳秉叡等20人擬具「會計師法部分條文修正草案」案。（詢答及處理）\n四、審查本院委員吳秉叡等21人、委員李彥秀等18人分別擬具「證券交易稅條例第二條之一條文修正草案」等2案。（僅詢答）\n【7月1日及2日二天一次會】）","transcript":{"pyannote":[{"speaker":"SPEAKER_02","start":1.7353437500000002,"end":2.56221875},{"speaker":"SPEAKER_02","start":3.2372187500000003,"end":4.95846875},{"speaker":"SPEAKER_02","start":5.4478437500000005,"end":5.90346875},{"speaker":"SPEAKER_02","start":6.308468750000001,"end":7.43909375},{"speaker":"SPEAKER_00","start":7.43909375,"end":7.45596875},{"speaker":"SPEAKER_02","start":7.5572187500000005,"end":7.64159375},{"speaker":"SPEAKER_02","start":8.265968750000003,"end":10.18971875},{"speaker":"SPEAKER_00","start":11.15159375,"end":12.332843750000002},{"speaker":"SPEAKER_00","start":12.602843750000002,"end":13.51409375},{"speaker":"SPEAKER_00","start":14.324093750000003,"end":14.813468750000002},{"speaker":"SPEAKER_02","start":14.813468750000002,"end":14.83034375},{"speaker":"SPEAKER_02","start":15.775343750000001,"end":16.90596875},{"speaker":"SPEAKER_02","start":17.04096875,"end":17.68221875},{"speaker":"SPEAKER_00","start":17.09159375,"end":17.69909375},{"speaker":"SPEAKER_02","start":17.69909375,"end":17.715968750000002},{"speaker":"SPEAKER_02","start":19.184093750000002,"end":23.21721875},{"speaker":"SPEAKER_02","start":23.352218750000002,"end":23.43659375},{"speaker":"SPEAKER_02","start":23.554718750000003,"end":28.566593750000003},{"speaker":"SPEAKER_02","start":28.92096875,"end":53.963468750000004},{"speaker":"SPEAKER_02","start":54.43596875,"end":57.102218750000006},{"speaker":"SPEAKER_02","start":57.540968750000005,"end":64.64534375000001},{"speaker":"SPEAKER_02","start":65.13471875,"end":77.18346875},{"speaker":"SPEAKER_02","start":78.24659375,"end":80.59221875},{"speaker":"SPEAKER_02","start":80.72721875,"end":82.04346875},{"speaker":"SPEAKER_02","start":82.87034375,"end":83.86596875000001},{"speaker":"SPEAKER_02","start":84.55784375,"end":85.55346875000001},{"speaker":"SPEAKER_02","start":85.85721875,"end":90.26159375},{"speaker":"SPEAKER_02","start":90.41346875,"end":90.88596875},{"speaker":"SPEAKER_02","start":92.13471875,"end":107.45721875000001},{"speaker":"SPEAKER_02","start":107.89596875000001,"end":115.21971875000001},{"speaker":"SPEAKER_02","start":116.23221875,"end":125.26034375},{"speaker":"SPEAKER_02","start":125.56409375000001,"end":128.21346875},{"speaker":"SPEAKER_02","start":128.71971875,"end":132.51659375},{"speaker":"SPEAKER_00","start":131.68971875,"end":132.56721875},{"speaker":"SPEAKER_00","start":132.90471875,"end":133.00596875000002},{"speaker":"SPEAKER_00","start":133.12409375000001,"end":157.12034375000002},{"speaker":"SPEAKER_02","start":149.39159375,"end":149.50971875000002},{"speaker":"SPEAKER_01","start":152.64846875,"end":152.86784375000002},{"speaker":"SPEAKER_00","start":157.84596875,"end":165.99659375000002},{"speaker":"SPEAKER_01","start":163.31346875,"end":163.70159375},{"speaker":"SPEAKER_00","start":166.63784375,"end":171.91971875000002},{"speaker":"SPEAKER_00","start":172.18971875,"end":184.45784375000002},{"speaker":"SPEAKER_01","start":178.21409375000002,"end":178.63596875000002},{"speaker":"SPEAKER_01","start":181.42034375,"end":181.58909375000002},{"speaker":"SPEAKER_00","start":184.82909375,"end":192.33846875},{"speaker":"SPEAKER_02","start":187.12409375000001,"end":187.51221875000002},{"speaker":"SPEAKER_02","start":191.81534375,"end":196.01721875},{"speaker":"SPEAKER_00","start":194.86971875,"end":224.99159375000002},{"speaker":"SPEAKER_01","start":203.76284375,"end":203.89784375000002},{"speaker":"SPEAKER_01","start":204.03284375,"end":204.16784375},{"speaker":"SPEAKER_01","start":210.44534375,"end":210.68159375000002},{"speaker":"SPEAKER_01","start":217.29659375000003,"end":217.36409375000002},{"speaker":"SPEAKER_02","start":217.36409375000002,"end":217.68471875},{"speaker":"SPEAKER_01","start":217.68471875,"end":217.70159375},{"speaker":"SPEAKER_02","start":224.83971875,"end":246.43971875000003},{"speaker":"SPEAKER_01","start":246.57471875000002,"end":257.15534375000004},{"speaker":"SPEAKER_01","start":257.45909375,"end":266.48721875},{"speaker":"SPEAKER_01","start":266.99346875000003,"end":268.02284375},{"speaker":"SPEAKER_01","start":268.20846875,"end":271.95471875000004},{"speaker":"SPEAKER_02","start":269.91284375000004,"end":282.61971875},{"speaker":"SPEAKER_01","start":282.45096875,"end":294.93846875},{"speaker":"SPEAKER_02","start":294.31409375000004,"end":344.33159375},{"speaker":"SPEAKER_02","start":344.97284375000004,"end":346.86284375},{"speaker":"SPEAKER_02","start":346.98096875000005,"end":348.39846875},{"speaker":"SPEAKER_02","start":349.19159375000004,"end":349.52909375},{"speaker":"SPEAKER_02","start":349.73159375,"end":352.29659375},{"speaker":"SPEAKER_00","start":352.56659375000004,"end":354.33846875},{"speaker":"SPE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癌症一些相關治療事實上不需要到醫院去現在醫院我們衛福部這邊也有在推就是在宅"},{"start":54.577,"end":62.241,"text":"化療 就在家裡做治療啦然後做 或是做門診手術那減少那個 因為現在醫護人員也比較不夠 不夠的情況下去擠在這個醫院裡頭 事實上增進增加這個醫院的這個loading嘛那原來保險這個目的是為了分擔風險嘛但是醫療技術進步以後 這個保險理賠這個退步嘛 就是時代改變嘛那我知道你們這個"},{"start":82.938,"end":89.818,"text":"相關單位好像有請相關的業者過來喝咖啡"},{"start":94.057,"end":114.624,"text":"討論這件事情現在醫療技術進步但是舊的保單又不能賠不能賠的話大家就只好去住院住院又搶病床真正需要的人就會造成住到院醫療資源又浪費但是你們6月10號去討論的結果好像成效不髒"},{"start":116.274,"end":132.233,"text":"你看看我們這個研究出來是只有30%是個案通融就是白內障少數特定項目其他的還是沒有辦法你們那邊討論的結果大概是怎樣我想看是誰去"},{"start":133.194,"end":156.816,"text":"我想先跟原則性的東西先跟委員報告那局長會跟您報告這一段時間以來其實不是我們這一段時間以來跟業界跟我們衛福部討論的一些比較有共識的地方其實我跟委員報告剛才倒不是說保險退步我想委員你想想看保險沒有與時俱進沒有進步則是退步啊就是說我想只是講一個很簡單的概念"},{"start":157.918,"end":183.887,"text":"假設我們一個20年前我們簽的保單20年前誰能夠預想到今天會發生什麼事情這個是必須這個是非常客觀的事實當這件事情發生的時候這個契約應該如何的去因應這新的狀況是完全按照契約的規定還是要重新把契約把它改變這牽涉到一個非常非常這個嚴肅的問題因為保險契約是長期契約它就是一個"},{"start":185.428,"end":203.482,"text":"簽約在前但是事件在後所以我們剛才講說有兩個很重要的原則待會我就請局長跟你說明不用其實你回答也可以因為你是專家就兩個很簡單的概念就是說還是回到那個公平合理跟對價橫貧就是說當時我在算費率已經跟你算進去的時候"},{"start":204.142,"end":219.58,"text":"那事後呢你就不可以因為說醫療這樣說我這樣沒有就不用理賠這不符合我們的對價橫貧再來就是我們的公平合理就是說這時候呢這樣做的時候呢你突然因為這醫療進步某方得利這樣由另外一方面來承擔當時無法"},{"start":220.942,"end":245.24,"text":"無法預知的這樣的風險那也是不符合公民合理原則而且從那個社會公益的角度來講對不對那如果說讓大家為了要去得到這個理賠只好去住院那又去搶這個病床那現在醫療這個病床又不夠的情況下對社會整體的社會進步事實上也是減分的嘛那保險那個好那你們也有這樣的想法那你們去跟這個相關業者討論以後他們現在怎麼說呢"},{"start":247.681,"end":257.823,"text":"報告委員 6月10號我們是大概廣泛的去收集受訓業者的意見包括哪些項目因為醫療技術的進步過去舊的住院醫療的保單到底怎麼來調適科技的進步這部分大家還是討論出來因為這還是要回到剛剛主委講的"},{"start":270.666,"end":294.374,"text":"就是說你們跟他們討論的結果事實上根據我們的相關報導這個事實上效果沒有那麼好啦但還有很大的進步空間嘛你們這個是不是應該要繼續來努力啊是 跟委員報告這部分因為業者盤點出來的效果就是過去曾經有個案融通的一些案例那就是根據過去因為保單都在不同時期發的他的契約條款還有他的保單"},{"start":294.494,"end":304.722,"text":"我覺得這個金管會這個部分是不是要整個的再來思考一下那我們回頭來看這個整個對整體這個社會的大的影響尤其特別我們來針對金門來講一下那金門鄉親到台灣來金門鄉親到台灣來要住院現在沒有病床嘛"},{"start":311.047,"end":331.392,"text":"那現在要推這一種叫做在家的這個化在家裡做的這個部分那我們離島相信事實上也有一些困難嘛那因為大部分的人也希望在家做化療的時候是要在醫院附近比較近的地方即時性萬一臨時有什麼事情的時候可以馬上就得到這個相關的這個專業的這個照顧嘛"},{"start":333.672,"end":348.158,"text":"那本島的這個保護他可能就改用這個居家照護啦齁那但是我們離島的這個保護就離島的這個金門鄉間好了沒有病床然後又沒有辦法能夠在金門自己做"},{"start":350.499,"end":368.738,"text":"醫療也還不足 這個怎麼做呢所以跟委員提到 像委員舉的就是一個很好的例子我們如果將近有保險 不可能得到相關的保障啊所以說委員剛才提到的就是一個很好的例子假設我當時買的時候 我是買一個住院那我確實真的要住院 因為我客觀條件不允許我住院"},{"start":369.551,"end":394.79,"text":"但是因為你那個保險規定一定要在醫院住院才能給付所以大家都去搶病床我們也搶不贏別人啊委員聽我講完就是說我說我剛才講的公平合理原則很重要這是我們定在金融消費者保護法裡面非常重要的一個法治判斷的原則就是說假設有一個人他的狀況他已經要本來就是要住院了"},{"start":395.47,"end":416.562,"text":"但是因為他客觀的條件讓他無法住院比如說住在離島是嗎比如說你突然颱風來我沒辦法中那我只能用這個方式的話那實際上這個狀況如果從公平合理來判斷的話他應該是符合我的給付的要件只是因為客觀條件不能的話我選擇這個如果能夠達到這個條件我覺得這是公平合理就可以來啟動對不對"},{"start":418.203,"end":433.86,"text":"但是假設我本來就不用住院但是我一旦住院就可以得到給付這是我們講的道德風險他本來就不需要給付的那什麼叫需不需要住院因為現在醫療技術進步以前要住院才能做手術現在就不用住院能做嗎所以說過去的"},{"start":435.361,"end":456.151,"text":"醫療保單把這個判准交給專業的醫師對 當然當然但是因為醫療技術進步以前要住院現在就不要住院剛我們說保險公司他得到了進步的這個利益所以說假設以白內障手術就是最典型的例子以前20年前你做白內障手術你必須要住院對 剛有講過就你們講的那30%你們隆峰這個有講那像比如說癌症這種你們還是沒有大的這種比較事實上"},{"start":463.914,"end":484.731,"text":"癌症這種是比較重的啦需求是化療也好像鄉親來台灣做化療什麼這些都是有需求的癌症的專屬保安是問題還比較單純比如說當時我在計算費率的時候就已經把化療算進去了那當然不會以住院為條件來判準這個部分的話就是還是一樣公平合理原則跟對價橫平"},{"start":486.152,"end":511.941,"text":"好 我想請說 請那個金管會尤其是保險局特別針對離島地區當然我們是針對金門地區針對保護居住在離島那如果當地的醫生已經判斷達到住院的這個標準但是因為客觀的限制比如說沒有病床 設備不足跨海到台灣來轉診困難要改為門診 在家化療或是在宅的急診照護那這個保險公司是針對這個部分應該針對離島的這個認定要一個"},{"start":516.277,"end":524.63,"text":"一個標準整個本島的居民情形是不一樣的我想這種比較特別的情況我請那個保局給你做完整的回覆就剛剛那個概念"},{"start":530.179,"end":548.018,"text":"我們會後再給你完整的另外一個我們事實上也有想過針對我們金門鄉親因為沒有辦法在台灣有居住的地方或沒有辦法這樣看我們事實上金門先生我有在思考以後就是說也許在金門先生可以提供相關的住宿的場所"},{"start":550.561,"end":574.082,"text":"給這個跨海救診的鄉親有住的地方那這個部分也許也可以跟地方政府來配合以後也可以跟地方政府配合地方政府可以出具一定的相關的證明證明的確是在宅在宅治療的這個部分啦這個如果公部門跟你們跟這個相關這個配合的話我想這個部分也可以往前的推進啦這也是我們最近跟衛福部在密切溝通就是說怎麼樣做一個專業認定因為"},{"start":575.919,"end":591.948,"text":"委員很清楚這個東西涉及到醫療專業的判斷保險公司沒辦法判斷而且他判斷出來大家也不會認為是具有公信力所以這一點也是為什麼我們要跟衛福部來商量來溝通就怎麼樣像該符合那個醫療的要件的話"},{"start":592.688,"end":603.655,"text":"那我們會來做一個比較好的決定那請你在這個解決這個問題的同時特別針對離島的居民特別要跟這個保險業者特別提這一塊這塊怎麼樣特別列一些條款出來好嗎那這個部分保險局什麼時候給我給我一個整體的這個報告什麼時候一個月了一個月好那麻煩你了謝謝主委"}]}},"supported_relations":[],"relations":[]}