You're right, you can make a higher wage and start on IBR.
Wait a minute, I remember you two now! Nelnet loans, 7.5 APR. You and your wife went to medical school and your loans are about 1M now, right? Last we talked I gave you a lot of information about IDR plans and loan forgiveness but you understandably were leaning towards paying them off in case PSLF continued to malfunction.
I rarely, rarely say this but given your circumstances, I actually agree with where you seemed to be leaning: refinancing. If you could get a private loan you could get a much lower APR, maybe even half that. You mentioned before how the (minimal?) payments didn't even cover the interest. In this case, on IBR (or for a much greater benefit REPAYE if you qualified), does have a temporary income subsidy. Not if you're talking about making larger payments to pay it off though. The additional benefit of any IDR plan is that the interest won't capitalize. Also not useful if you're already paying off the interest and a chunk of the principal. The most benefit you could get on either plan is consolidation (which might not be worth it depending on how the APRs will combine to come up with the final APR) and direct debit payments. This will only save you 0.25% I believe.
With the income of you and your wife, both of your debt, job security and the insurance, I would definitely say that if you could get a loan(s) for the amount then that would be a great savings to you both.
The other option might be to get a loan in a lesser amount, pay off that portion, put the loan in forbearance for a year and pay off the bank loan. At least that will be a portion that won't be at the higher APR.
As for your original question, neither plan is better or worse. You're kind of outside of most of the benefits of federal loans for it to make a difference.
