I have the VIP 211k reciever + Tailgater antenna bundle, and I am very very happy with it. There is no setup fee that I am aware of; the hardware costs $500 so I think Dish has got enough of my money.
The Tailgater is so easy to use. Since this was my first experience with Sat, I can't compare to Direct, but the service seems great and the Dish works as advertised. Note: Instead of the stock 50-foot cable that came with the package, I bought a low-loss 100-ft cable ($17 on Amazon) and it works just fine. This allows me to strut the Tailgater out further in search of a clear southern view.
The main benefit of the Tailgater is ease of use. If you have experience aiming sat antennas, then there are more powerful options available. But the reception with the Tailgater is just fine and--did I mention it was easy?
Highly recommended!