I think Z is partially right.
Q: Is dialysis expensive? A: Yes. Dialysis costs a lot of money. However, the federal government pays 80 percent of all dialysis costs for most patients. Private health insurance or state Medicaid programs also help with the costs.
I actually don't know who guarantees payment.
I do know I haven't read one news story in my entire life where someone died because he couldn't afford the co-pay.