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I think part of the reason that utilities can get away with this is the fact that the maximum bill you are likely to run up is generally 2x-3x your normal bill. This doesn't well for Amazon because your actual bill can be orders of magnitude larger than what you expect.

And every now and then a utility bill makes the news because someone's water line sprung a leak and they used $5000 worth of water in a month.

What's the quote? Something like, "At some point a quantitative difference becomes a qualitative difference."

I know two people near my parents who've ended up with $30,000+ water bills for a single month.

I'm sure they see it that way. The problem here is that they aren't a utility unless the utility was also selling air conditioners and microwaves, and those air conditioners and microwaves had a button that said "Charge met 10x my normal bill this month" on them.

Offering the option to cap expenditures doesn't affect anyone that chooses to not use that feature.