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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"}],"gazette":[{"speaker":"陳委員玉珍","start":"2026-07-01T11:14:11+08:00","guessed":true,"end":"2026-07-01T11:14:12+08:00","text":"謝謝主席，有請主委。","quality":0},{"speaker":"主席","start":"2026-07-01T11:14:12+08:00","guessed":true,"end":"2026-07-01T11:14:13+08:00","text":"請金管會彭主委。","quality":0},{"speaker":"陳委員玉珍","start":"2026-07-01T11:14:13+08:00","guessed":true,"end":"2026-07-01T11:14:14+08:00","text":"保險局有來嗎？","quality":0},{"speaker":"主席","start":"2026-07-01T11:14:12.815000+08:00","guessed":false,"end":"2026-07-01T11:14:13.335000+08:00","text":"請保險局王局長。","quality":0.857},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:14:13.335000+08:00","guessed":true,"end":"2026-07-01T11:14:19.026333+08:00","text":"委員好。","quality":0},{"speaker":"陳委員玉珍","start":"2026-07-01T11:14:19.026333+08:00","guessed":true,"end":"2026-07-01T11:14:24.717667+08:00","text":"主委，辛苦了。","quality":0},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:14:24.717667+08:00","guessed":true,"end":"2026-07-01T11:14:30.409000+08:00","text":"不會，謝謝。","quality":0},{"speaker":"陳委員玉珍","start":"2026-07-01T11:14:30.409000+08:00","guessed":false,"end":"2026-07-01T11:14:45.126000+08:00","text":"現在醫療技術升級了，我們看到有很多保險的部分，現在都在討論要住院才能申請保險理賠，因為以前的保單都是住院一天給多少錢嘛！","quality":0.839},{"speaker":"陳委員玉珍","start":"2026-07-01T11:14:45.126000+08:00","guessed":false,"end":"2026-07-01T11:14:49.751000+08:00","text":"現在因為醫療技術升級很多，現在不是又很缺病床嗎？","quality":1},{"speaker":"陳委員玉珍","start":"2026-07-01T11:14:50.412000+08:00","guessed":false,"end":"2026-07-01T11:15:11.020000+08:00","text":"所以醫療技術升級的結果是很多病，像是癌症等相關治療事實上已不需要到醫院去，現在衛福部這邊也有在推在宅化療，也就是在家裡做治療，或是做門診手術，減少那個……因為現在醫護人員也比較不夠，在不夠的情況下要擠在醫院裡頭，事實上是增加醫院的loading。","quality":0.92},{"speaker":"陳委員玉珍","start":"2026-07-01T11:15:11.340000+08:00","guessed":false,"end":"2026-07-01T11:15:12.621000+08:00","text":"原來保險的目的是為了分攤風險，但是醫療技術進步以後，保險理賠就退步了，因為時代改變了嘛！","quality":0.825},{"speaker":"陳委員玉珍","start":"2026-07-01T11:15:12.801000+08:00","guessed":false,"end":"2026-07-01T11:15:40.798000+08:00","text":"我知道你們相關單位好像有請相關的業者過來喝咖啡，對吧？","quality":0.92},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:15:40.798000+08:00","guessed":true,"end":"2026-07-01T11:15:45.057000+08:00","text":"是討論啦！","quality":0},{"speaker":"陳委員玉珍","start":"2026-07-01T11:15:45.057000+08:00","guessed":false,"end":"2026-07-01T11:15:45.397000+08:00","text":"好，是討論這件事情啦！","quality":0.667},{"speaker":"陳委員玉珍","start":"2026-07-01T11:15:47.217000+08:00","guessed":false,"end":"2026-07-01T11:16:01.882000+08:00","text":"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，住院又要搶病床，真正需要的人就住不到院，醫療資源就浪費了。","quality":0.93},{"speaker":"陳委員玉珍","start":"2026-07-01T11:16:01.882000+08:00","guessed":false,"end":"2026-07-01T11:16:05.604000+08:00","text":"但是你們6月10號討論的結果好像成效不彰耶！","quality":0.889},{"speaker":"陳委員玉珍","start":"2026-07-01T11:16:07.274000+08:00","guessed":false,"end":"2026-07-01T11:16:18.928000+08:00","text":"你看看我們研究出來的，只有30%的個案有通融，就是白內障等少數特定項目有妥協，其他的還是沒有辦法。","quality":0.837},{"speaker":"陳委員玉珍","start":"2026-07-01T11:16:20.590000+08:00","guessed":false,"end":"2026-07-01T11:16:22.012000+08:00","text":"你們那天討論的結果大概是怎樣？","quality":0.929},{"speaker":"陳委員玉珍","start":"2026-07-01T11:16:22.012000+08:00","guessed":false,"end":"2026-07-01T11:16:23.213000+08:00","text":"我想，看是誰去……","quality":1},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:16:24.194000+08:00","guessed":false,"end":"2026-07-01T11:16:35.365000+08:00","text":"我想先就原則性的部分跟委員報告，局長會再跟你報告這段時間以來跟業界、衛福部討論到比較有共識的一些地方。","quality":0.833},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:16:35.925000+08:00","guessed":false,"end":"2026-07-01T11:16:39.989000+08:00","text":"我跟委員報告，倒不是說保險退步，委員你想想看……","quality":1},{"speaker":"陳委員玉珍","start":"2026-07-01T11:16:40.369000+08:00","guessed":false,"end":"2026-07-01T11:16:43.672000+08:00","text":"好，是保險沒有與時俱進，沒有進步就是退步。","quality":0.833},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:16:44.573000+08:00","guessed":false,"end":"2026-07-01T11:16:54.120000+08:00","text":"不是，我只講一個很簡單的概念，假設一張20年前簽的保單，20年前誰能夠預想到今天會發生什麼事情？","quality":0.95},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:16:54.540000+08:00","guessed":false,"end":"2026-07-01T11:17:08.325000+08:00","text":"這是非常客觀的事實，當這件事情發生的時候，這個契約要如何去因應這個新的狀況，是完全按照契約的規定，還是要重新改變契約？","quality":0.926},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:17:09.625000+08:00","guessed":false,"end":"2026-07-01T11:17:19.050000+08:00","text":"這牽涉到非常嚴肅的問題，因為保險契約是長期契約，它就是一個簽約在前，但事件在後，所以常常會遇到這種問題。","quality":0.809},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:17:19.310000+08:00","guessed":false,"end":"2026-07-01T11:17:23.113000+08:00","text":"我剛才講到有兩個很重要的原則，待會就請局長跟你說明……","quality":0.958},{"speaker":"陳委員玉珍","start":"2026-07-01T11:17:23.493000+08:00","guessed":false,"end":"2026-07-01T11:17:24.954000+08:00","text":"不用，你回答也可以，因為你是專家。","quality":1},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:17:25.855000+08:00","guessed":false,"end":"2026-07-01T11:17:55.805000+08:00","text":"就是兩個很簡單的概念，還是要回到公平合理跟對價衡平的原則上，當初在算費率時已經把它算進去了，事後你就不可以因為醫療這樣就認為我沒有用到而不用理賠，這樣就不符合對價衡平；再來就是公平合理的原則，這時這樣做，你突然因為醫療的進步讓某方得利，就由另外一方承擔當時無法預知的風險，這樣也不符合公平合理原則。","quality":0.77},{"speaker":"陳委員玉珍","start":"2026-07-01T11:17:55.805000+08:00","guessed":false,"end":"2026-07-01T11:18:12.097000+08:00","text":"對，而且從社會公義的角度來講，如果讓大家為了去得到這個理賠，只好去住院，去搶這個病床，在現在醫療病床不夠的情況下，對社會整體的進步事實上也是減分的嘛！","quality":0.956},{"speaker":"陳委員玉珍","start":"2026-07-01T11:18:13.798000+08:00","guessed":false,"end":"2026-07-01T11:18:16.220000+08:00","text":"既然你們也有這樣的想法，你們跟相關業者討論以後，他們現在是怎麼說的呢？","quality":0.875},{"speaker":"王局長麗惠","start":"2026-07-01T11:18:18.681000+08:00","guessed":false,"end":"2026-07-01T11:18:26.943000+08:00","text":"報告委員，6月10號我們大概是廣泛地蒐集壽險業者的意見，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要怎麼來調適，以因應科技的進步？","quality":0.862},{"speaker":"王局長麗惠","start":"2026-07-01T11:18:26.963000+08:00","guessed":false,"end":"2026-07-01T11:18:28.803000+08:00","text":"這部分大家討論出來的，還是要回到剛剛主委講的……","quality":0.952},{"speaker":"陳委員玉珍","start":"2026-07-01T11:18:41.766000+08:00","guessed":false,"end":"2026-07-01T11:18:53.450000+08:00","text":"是，你們跟他們討論的結果，根據相關的報導，事實上效果沒有那麼好，當然還有很大的進步空間，你們對此是不是應該要繼續努力啊？","quality":0.907},{"speaker":"王局長麗惠","start":"2026-07-01T11:18:53.770000+08:00","guessed":false,"end":"2026-07-01T11:19:05.354000+08:00","text":"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，因為保單都是在不同時期發的，它的契約條款還有它的保障……","quality":0.933},{"speaker":"陳委員玉珍","start":"2026-07-01T11:19:05.494000+08:00","guessed":false,"end":"2026-07-01T11:19:08.817000+08:00","text":"我覺得金管會是不是要就這個部分再整個去思考一下？","quality":0.696},{"speaker":"陳委員玉珍","start":"2026-07-01T11:19:09.437000+08:00","guessed":false,"end":"2026-07-01T11:19:14.621000+08:00","text":"我們回頭來看，這對整個社會整體有很大的影響，我們尤其要特別針對金門來講一下。","quality":0.8},{"speaker":"陳委員玉珍","start":"2026-07-01T11:19:15.102000+08:00","guessed":false,"end":"2026-07-01T11:19:25.068000+08:00","text":"金門鄉親到臺灣來要住院，現在沒有病床，所以要推在家化……","quality":0.917},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:19:25.068000+08:00","guessed":true,"end":"2026-07-01T11:19:26.068000+08:00","text":"在宅醫療。","quality":0.25},{"speaker":"陳委員玉珍","start":"2026-07-01T11:19:25.768000+08:00","guessed":false,"end":"2026-07-01T11:19:27.388000+08:00","text":"就是在家做的部分。","quality":0.625},{"speaker":"陳委員玉珍","start":"2026-07-01T11:19:28.208000+08:00","guessed":false,"end":"2026-07-01T11:19:42.372000+08:00","text":"我們離島鄉親事實上也有一些困難，因為大部分的人也希望在家做化療的時候可以在醫院附近，就是距離比較近的地方，較具即時性，萬一臨時有什麼事情的話，就可以馬上得到相關而專業的照顧嘛！","quality":0.841},{"speaker":"陳委員玉珍","start":"2026-07-01T11:19:45.152000+08:00","guessed":false,"end":"2026-07-01T11:19:57.417000+08:00","text":"本島的保戶可能就是改用居家照護，但是我們離島的保戶，也就是離島的金門鄉親沒有病床，又沒有辦法……","quality":0.86},{"speaker":"陳委員玉珍","start":"2026-07-01T11:19:58.657000+08:00","guessed":false,"end":"2026-07-01T11:19:59.138000+08:00","text":"難道叫金門自己做？","quality":0.625},{"speaker":"陳委員玉珍","start":"2026-07-01T11:20:01.499000+08:00","guessed":false,"end":"2026-07-01T11:20:03.041000+08:00","text":"醫療也還不足，這個怎麼做呢？","quality":1},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:20:04.042000+08:00","guessed":false,"end":"2026-07-01T11:20:07.345000+08:00","text":"對，所以跟委員提到，像委員舉的一個很好的例子……","quality":0.95},{"speaker":"陳委員玉珍","start":"2026-07-01T11:20:08.066000+08:00","guessed":false,"end":"2026-07-01T11:20:10.608000+08:00","text":"如果鄉親有保險，他也不可能得到相關的保障啊！","quality":0.8},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:20:10.849000+08:00","guessed":false,"end":"2026-07-01T11:20:19.718000+08:00","text":"對，所以委員剛剛提到的就是一個很好的例子，假設我當時買保險的時候是買住院，我確實真的要住院，但因為我的客觀條件不允許我住院，不是……","quality":0.864},{"speaker":"陳委員玉珍","start":"2026-07-01T11:20:20.551000+08:00","guessed":false,"end":"2026-07-01T11:20:30.338000+08:00","text":"但是因為保險是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！","quality":0.974},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:20:31.239000+08:00","guessed":false,"end":"2026-07-01T11:20:48.831000+08:00","text":"委員，聽我講完，我說我剛才講的公平合理原則很重要，這是我們訂在金融消費者保護法裡面非常重要的一個法制判斷的原則，就是假設有一個人的狀況本來就是要住院了，但是因為客觀的條件讓他無法住院……","quality":0.977},{"speaker":"陳委員玉珍","start":"2026-07-01T11:20:49.852000+08:00","guessed":false,"end":"2026-07-01T11:20:51.553000+08:00","text":"對，比如說住在離島，是嗎？","quality":0.9},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:20:51.553000+08:00","guessed":false,"end":"2026-07-01T11:21:07.562000+08:00","text":"對，比如說突然颱風來，我沒辦法住院，我只能用這個方式，實際上這個狀況如果從公平合理來判斷的話，他應該是符合給付要件，只是因為客觀條件不能，所以我選擇這個，如果能夠達到這個條件，我覺得這是公平合理原則就可以來啟動的，對不對？是。","quality":0.911},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:21:09.203000+08:00","guessed":false,"end":"2026-07-01T11:21:16.731000+08:00","text":"但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，他自己創造……","quality":0.898},{"speaker":"陳委員玉珍","start":"2026-07-01T11:21:17.953000+08:00","guessed":false,"end":"2026-07-01T11:21:24.079000+08:00","text":"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，現在不用住院就能做。","quality":0.974},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:21:24.359000+08:00","guessed":false,"end":"2026-07-01T11:21:29.803000+08:00","text":"對，所以過去的醫療保單把這個判准交給專業的醫師……","quality":0.955},{"speaker":"陳委員玉珍","start":"2026-07-01T11:21:29.803000+08:00","guessed":false,"end":"2026-07-01T11:21:38.307000+08:00","text":"對，當然、當然，但是因為醫療技術進步，以前要住院的，現在不用住院，剛剛我們說保險公司得到了科技進步的利益。","quality":0.891},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:21:39.387000+08:00","guessed":false,"end":"2026-07-01T11:21:44.689000+08:00","text":"對，白內障手術就是最典型的例子，二十年前做白內障手術必須要住院……","quality":0.897},{"speaker":"陳委員玉珍","start":"2026-07-01T11:21:44.990000+08:00","guessed":false,"end":"2026-07-01T11:21:57.596000+08:00","text":"對，剛剛有講過，就是你們講的30%融通，但像是癌症這種，你們還是沒有一個比較大的……事實上癌症這種是比較嚴重的。","quality":0.766},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:21:57.596000+08:00","guessed":true,"end":"2026-07-01T11:21:58.596000+08:00","text":"癌症的部分，假設說你當時……","quality":0},{"speaker":"陳委員玉珍","start":"2026-07-01T11:21:58.337000+08:00","guessed":false,"end":"2026-07-01T11:22:03.021000+08:00","text":"需求是化療等等也好，像金門鄉鄉親來臺灣做化療什麼的，這也都是有需求的。","quality":0.781},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:22:03.541000+08:00","guessed":false,"end":"2026-07-01T11:22:17.152000+08:00","text":"對，癌症的專屬保單，這個問題還比較單純，如果當時在計算費率的時候就已經把化療算進去了，當然不會以住院為條件來判准，這個部分就還是一樣是公平合理原則跟對價衡平。好。","quality":0.892},{"speaker":"陳委員玉珍","start":"2026-07-01T11:22:17.532000+08:00","guessed":false,"end":"2026-07-01T11:22:50.642000+08:00","text":"我想請金管會，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，保護居住在離島的居民，如果當地醫生判斷已經達到住院標準，但是因為客觀上的限制，比如沒有病床、設備不足、跨海到臺灣的轉診困難，要改為門診、在家化療或是在宅的急症照護，保險公司針對離島部分的認定要有一個標準，這跟本島居民的情形是不一樣的。","quality":0.899},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:22:50.823000+08:00","guessed":false,"end":"2026-07-01T11:22:55.610000+08:00","text":"我想這種比較特別的情形，我請保局給你做完整的回復，就是剛才講的那個概念。","quality":0.818},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:23:01.179000+08:00","guessed":false,"end":"2026-07-01T11:23:04.383000+08:00","text":"我們會後再給你完整的資料。好。","quality":0.769},{"speaker":"陳委員玉珍","start":"2026-07-01T11:23:05.704000+08:00","guessed":false,"end":"2026-07-01T11:23:41.218000+08:00","text":"另外，我們事實上也有想過，針對我們金門鄉親，因為沒有辦法在臺灣有居住的地方，或沒有辦法這樣看診，事實上我也在思考以後也許在金門縣可以提供相關住宿場所給跨海就診的鄉親有住的地方，這個部分也許可以跟地方政府來配合，地方政府可以出具一定的相關證明，證明的確是在宅治療，如果公部門跟你們來配合相關事宜的話，我想這個部分也可以往前推進。","quality":0.941},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:23:41.338000+08:00","guessed":false,"end":"2026-07-01T11:24:05.149000+08:00","text":"對，這也是我們最近跟衛福部在密切溝通的，就是怎麼樣做專業的認定，委員也很清楚，因為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、溝通的，怎麼樣符合相關的醫療要件，我們會來做一個比較好的處理。","quality":0.906},{"speaker":"陳委員玉珍","start":"2026-07-01T11:24:05.509000+08:00","guessed":false,"end":"2026-07-01T11:24:12.073000+08:00","text":"好，請你在解決這個問題的同時，要特別針對離島的居民跟保險業者提這一塊……","quality":0.938},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:24:12.073000+08:00","guessed":true,"end":"2026-07-01T11:24:13.073000+08:00","text":"就把客觀事實考慮進去。","quality":0},{"speaker":"陳委員玉珍","start":"2026-07-01T11:24:12.073000+08:00","guessed":false,"end":"2026-07-01T11:24:12.574000+08:00","text":"看這一塊怎麼樣特別列一些條款出來，好嗎？好。","quality":0.842},{"speaker":"陳委員玉珍","start":"2026-07-01T11:24:12.594000+08:00","guessed":false,"end":"2026-07-01T11:24:13.834000+08:00","text":"這個部分保險局什麼時候給我一個整體的報告？","quality":1},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:24:13.955000+08:00","guessed":false,"end":"2026-07-01T11:24:13.975000+08:00","text":"一個月。","quality":1},{"speaker":"陳委員玉珍","start":"2026-07-01T11:24:14.115000+08:00","guessed":false,"end":"2026-07-01T11:24:14.455000+08:00","text":"一個月，好，再麻煩你了。","quality":0.889},{"speaker":"彭主任委員金隆","start":"2026-07-01T11:24:14.455000+08:00","guessed":true,"end":"2026-07-01T11:24:15.455000+08:00","text":"是，沒問題，謝謝委員。","quality":0},{"speaker":"陳委員玉珍","start":"2026-07-01T11:24:14.515000+08:00","guessed":false,"end":"2026-07-01T11:24:14.635000+08:00","text":"謝謝主委。","quality":1},{"speaker":"主席","start":"2026-07-01T11:24:15.135000+08:00","guessed":true,"end":"2026-07-01T11:24:17.135000+08:00","text":"謝謝陳玉珍委員。","quality":0},{"speaker":"主席","start":"2026-07-01T11:24:17.435000+08:00","guessed":true,"end":"2026-07-01T11:24:20.577857+08:00","text":"下一位請王世堅委員質詢。","quality":0}]},"gazette":{"lineno":1119,"blocks":[["陳委員玉珍：（11時14分）謝謝主席，有請主委。"],["主席：請金管會彭主委。"],["陳委員玉珍：保險局有來嗎？"],["主席：請保險局王局長。"],["彭主任委員金隆：委員好。"],["陳委員玉珍：主委，辛苦了。"],["彭主任委員金隆：不會，謝謝。"],["陳委員玉珍：現在醫療技術升級了，我們看到有很多保險的部分，現在都在討論要住院才能申請保險理賠，因為以前的保單都是住院一天給多少錢嘛！現在因為醫療技術升級很多，現在不是又很缺病床嗎？所以醫療技術升級的結果是很多病，像是癌症等相關治療事實上已不需要到醫院去，現在衛福部這邊也有在推在宅化療，也就是在家裡做治療，或是做門診手術，減少那個……因為現在醫護人員也比較不夠，在不夠的情況下要擠在醫院裡頭，事實上是增加醫院的loading。","原來保險的目的是為了分攤風險，但是醫療技術進步以後，保險理賠就退步了，因為時代改變了嘛！我知道你們相關單位好像有請相關的業者過來喝咖啡，對吧？"],["彭主任委員金隆：是討論啦！"],["陳委員玉珍：好，是討論這件事情啦！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，住院又要搶病床，真正需要的人就住不到院，醫療資源就浪費了。但是你們6月10號討論的結果好像成效不彰耶！你看看我們研究出來的，只有30%的個案有通融，就是白內障等少數特定項目有妥協，其他的還是沒有辦法。你們那天討論的結果大概是怎樣？我想，看是誰去……"],["彭主任委員金隆：我想先就原則性的部分跟委員報告，局長會再跟你報告這段時間以來跟業界、衛福部討論到比較有共識的一些地方。我跟委員報告，倒不是說保險退步，委員你想想看……"],["陳委員玉珍：好，是保險沒有與時俱進，沒有進步就是退步。"],["彭主任委員金隆：不是，我只講一個很簡單的概念，假設一張20年前簽的保單，20年前誰能夠預想到今天會發生什麼事情？這是非常客觀的事實，當這件事情發生的時候，這個契約要如何去因應這個新的狀況，是完全按照契約的規定，還是要重新改變契約？這牽涉到非常嚴肅的問題，因為保險契約是長期契約，它就是一個簽約在前，但事件在後，所以常常會遇到這種問題。我剛才講到有兩個很重要的原則，待會就請局長跟你說明……"],["陳委員玉珍：不用，你回答也可以，因為你是專家。"],["彭主任委員金隆：就是兩個很簡單的概念，還是要回到公平合理跟對價衡平的原則上，當初在算費率時已經把它算進去了，事後你就不可以因為醫療這樣就認為我沒有用到而不用理賠，這樣就不符合對價衡平；再來就是公平合理的原則，這時這樣做，你突然因為醫療的進步讓某方得利，就由另外一方承擔當時無法預知的風險，這樣也不符合公平合理原則。"],["陳委員玉珍：對，而且從社會公義的角度來講，如果讓大家為了去得到這個理賠，只好去住院，去搶這個病床，在現在醫療病床不夠的情況下，對社會整體的進步事實上也是減分的嘛！既然你們也有這樣的想法，你們跟相關業者討論以後，他們現在是怎麼說的呢？"],["王局長麗惠：報告委員，6月10號我們大概是廣泛地蒐集壽險業者的意見，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要怎麼來調適，以因應科技的進步？這部分大家討論出來的，還是要回到剛剛主委講的……"],["陳委員玉珍：是，你們跟他們討論的結果，根據相關的報導，事實上效果沒有那麼好，當然還有很大的進步空間，你們對此是不是應該要繼續努力啊？"],["王局長麗惠：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，因為保單都是在不同時期發的，它的契約條款還有它的保障……"],["陳委員玉珍：我覺得金管會是不是要就這個部分再整個去思考一下？我們回頭來看，這對整個社會整體有很大的影響，我們尤其要特別針對金門來講一下。金門鄉親到臺灣來要住院，現在沒有病床，所以要推在家化……"],["彭主任委員金隆：在宅醫療。"],["陳委員玉珍：就是在家做的部分。我們離島鄉親事實上也有一些困難，因為大部分的人也希望在家做化療的時候可以在醫院附近，就是距離比較近的地方，較具即時性，萬一臨時有什麼事情的話，就可以馬上得到相關而專業的照顧嘛！本島的保戶可能就是改用居家照護，但是我們離島的保戶，也就是離島的金門鄉親沒有病床，又沒有辦法……","難道叫金門自己做？醫療也還不足，這個怎麼做呢？"],["彭主任委員金隆：對，所以跟委員提到，像委員舉的一個很好的例子……"],["陳委員玉珍：如果鄉親有保險，他也不可能得到相關的保障啊！"],["彭主任委員金隆：對，所以委員剛剛提到的就是一個很好的例子，假設我當時買保險的時候是買住院，我確實真的要住院，但因為我的客觀條件不允許我住院，不是……"],["陳委員玉珍：但是因為保險是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！"],["彭主任委員金隆：委員，聽我講完，我說我剛才講的公平合理原則很重要，這是我們訂在金融消費者保護法裡面非常重要的一個法制判斷的原則，就是假設有一個人的狀況本來就是要住院了，但是因為客觀的條件讓他無法住院……"],["陳委員玉珍：對，比如說住在離島，是嗎？"],["彭主任委員金隆：對，比如說突然颱風來，我沒辦法住院，我只能用這個方式，實際上這個狀況如果從公平合理來判斷的話，他應該是符合給付要件，只是因為客觀條件不能，所以我選擇這個，如果能夠達到這個條件，我覺得這是公平合理原則就可以來啟動的，對不對？"],["陳委員玉珍：是。"],["彭主任委員金隆：但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，他自己創造……"],["陳委員玉珍：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，現在不用住院就能做。"],["彭主任委員金隆：對，所以過去的醫療保單把這個判准交給專業的醫師……"],["陳委員玉珍：對，當然、當然，但是因為醫療技術進步，以前要住院的，現在不用住院，剛剛我們說保險公司得到了科技進步的利益。"],["彭主任委員金隆：對，白內障手術就是最典型的例子，二十年前做白內障手術必須要住院……"],["陳委員玉珍：對，剛剛有講過，就是你們講的30%融通，但像是癌症這種，你們還是沒有一個比較大的……事實上癌症這種是比較嚴重的。"],["彭主任委員金隆：癌症的部分，假設說你當時……"],["陳委員玉珍：需求是化療等等也好，像金門鄉鄉親來臺灣做化療什麼的，這也都是有需求的。"],["彭主任委員金隆：對，癌症的專屬保單，這個問題還比較單純，如果當時在計算費率的時候就已經把化療算進去了，當然不會以住院為條件來判准，這個部分就還是一樣是公平合理原則跟對價衡平。"],["陳委員玉珍：好。我想請金管會，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，保護居住在離島的居民，如果當地醫生判斷已經達到住院標準，但是因為客觀上的限制，比如沒有病床、設備不足、跨海到臺灣的轉診困難，要改為門診、在家化療或是在宅的急症照護，保險公司針對離島部分的認定要有一個標準，這跟本島居民的情形是不一樣的。"],["彭主任委員金隆：我想這種比較特別的情形，我請保局給你做完整的回復，就是剛才講的那個概念。我們會後再給你完整的資料。"],["陳委員玉珍：好。另外，我們事實上也有想過，針對我們金門鄉親，因為沒有辦法在臺灣有居住的地方，或沒有辦法這樣看診，事實上我也在思考以後也許在金門縣可以提供相關住宿場所給跨海就診的鄉親有住的地方，這個部分也許可以跟地方政府來配合，地方政府可以出具一定的相關證明，證明的確是在宅治療，如果公部門跟你們來配合相關事宜的話，我想這個部分也可以往前推進。"],["彭主任委員金隆：對，這也是我們最近跟衛福部在密切溝通的，就是怎麼樣做專業的認定，委員也很清楚，因為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、溝通的，怎麼樣符合相關的醫療要件，我們會來做一個比較好的處理。"],["陳委員玉珍：好，請你在解決這個問題的同時，要特別針對離島的居民跟保險業者提這一塊……"],["彭主任委員金隆：就把客觀事實考慮進去。"],["陳委員玉珍：看這一塊怎麼樣特別列一些條款出來，好嗎？"],["彭主任委員金隆：好。"],["陳委員玉珍：這個部分保險局什麼時候給我一個整體的報告？"],["彭主任委員金隆：一個月。"],["陳委員玉珍：一個月，好，再麻煩你了。"],["彭主任委員金隆：是，沒問題，謝謝委員。"],["陳委員玉珍：謝謝主委。"],["主席：謝謝陳玉珍委員。","下一位請王世堅委員質詢。"]],"agenda":{"page_end":556,"meet_id":"委員會-11-5-20-20","speakers":["吳秉叡","林德福","賴士葆","郭國文","林岱樺","劉書彬","賴惠員","李彥秀","顏寬恒","羅明才","陳玉珍","王世堅","李坤城","林楚茵","許忠信","楊瓊瓔","林思銘"],"page_start":1,"meetingDate":["2026-07-01"],"gazette_id":"1155602","agenda_lcidc_ids":["1155602_00002"],"meet_name":"立法院第11屆第5會期財政委員會第20次全體委員會議紀錄","content":"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\n報院會案；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\n部分審查總報告草案」提報院會案；三、審查本院委員吳秉叡等20人擬具「會計師法部分條文修\n正草案」案；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\n二條之一條文修正草案」等2案（詢答）","agenda_id":"1155602_00001"}}},"supported_relations":[],"relations":[]}