GOP lawmakers are defending their burden-shift argument with House Budget Committee Chairman Paul Ryan's leadership on a reform strategy for Medicare. Why not give retirees vouchers to spend on private insurance in a public exchange, if it's going to save the system from bankruptcy?

It's not a new concept. Employers eye consumer-driven health options as a cost solution to mitigate obscenely rising premiums. But, as Mark Miller of Reuters notes, it's a change that not many employers are ready for.

And while the substantive cost savings is apparent, Miller also points out, the expenditure reduction reflects mainly the cost shift from plan sponsors to enrollees. But "Is there any evidence of lower utilization and prices?"