What does the US dialysis entitlement say about public healthcare funding?

Donnia had her thread hijacked into a health care funding discussion. I think there's one perspective we haven't discussed - what does the dialysis entitlement teach us?

One thing people who favor a State sponsored system (basically any non-US first world model) fail to credit is that the US health care system is the worldwide driver of medical innovation. Doesn't the stagnation in the provision of dialysis suggest that public funding slows innovation? The world has been getting a free ride while US consumers have shoulder the cost of innovation.

However, fans of the US system fail to credit the inhumanity and unfairness of the inefficient structure we've inherited here in America.

I guess this is my liberal heterodoxy, I think the only savings available in the US system (per person, if we cover everyone it will cost more in total) are schemes that reconnect the supply and demand curves in a meaningful way, from the point of view of the care consumer. The only way I know how to do that is high deductible schemes aka some kind of medical savings account scheme. I think that the federal funding role should be the public health role. I think the federal government should provide chronic disease screening and on going care, while the private sector should provide acute disease/injury care through high deductible schemes.

What lessons do you see in the provision of dialysis and/or ckd care?