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You work as the health benefits manager for a county government. The county's employees are unionized and have health insurance through a managed care plan

You work as the health benefits manager for a county government. The county's employees are unionized and have health insurance through a managed care plan that you manage. The insurance plan requires no copays but does require that subscribers have a referral from a primary care physician to visit a specialist. You are now re-negotiating the union contract and the workers are very opposed to the referral requirement. As the benefits expert for the county, would you be willing to recommend that it abandon the referral requirement in exchange for physician visit copays of, say $30 per visit? Why or why not

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