That is the key point, net nuetrality is a moot point because if an ISP were to do something like charge for iplayer (BBC catchup service) which was mooted a few years ago, they'd all move to a different ISP.
Because we have for the moment a roughly open market.
There are parts that are controlled by a monopoly, but thats the people who provide the last mile infrastructure. They have strict regulations saying that they must charge a fixed price for rental of the infrastructure with no obligations other than to pay for the last mile. (they can choose to be a pure virtual operator, just skinning the service, or almost entirely run its own infra, save the last bit of copper)
Also, the people that run the last mile monopoly are not the people providing backhaul. That is mostly an open market too. More open than the last mile copper at least. Linx/lonap are all coops, where you pay a membership fee, and the cost of powering your equipment, any interconnect arrangements are up to you and your peers.
In short, we have a much more open market, but with no net nuetrality.
what america needs is competition, and the seperation of last mile, ISPs and backhaul. None of which you are going to get in present times.