Like I said, the most latency-sensitive topic I can relate to is first-person shooters; in particular, I play the game CS:GO, where one shot can knock you out of a round. I play within a 40ms ping area, generally around 20-30ms of ping, and that seems to get me (from California) more or less the whole west coast of America.

I experience virtually no issues from my internet, and like I said, I pay $30 a month for this service. I don't use a lot of band-width, I simply use a consistent stream, and I see no reason why I should have to pay more for that right. It's an automaton wiring packets, not people scrambling to move data.

Back to you, though: what sort of issues arise from this extreme sensitivity to latency you have? Is 'telehealth' just a doctor skyping with a patient or do you have some kind of real-time devices that depend on communication over a distance? If the latter, how sure are you that your architecture isn't the issue, and some computations couldn't be done in a different link in the chain?

>the REAL issue is local governments providing de facto monopoly power to ISPs

I totally agree. Like I literally said in my comment, the whole calculus of this conversation would change if ISPs actually had to compete, but since they obviously don't, I can't possibly see how revoking net neutrality is a good idea. It simply lets them tighten their stranglehold in a fashion that costs everyone more money and extends the anti-competitive sphere they exist in into the whole realm of business that relies on sending traffic over the internet.

So sure, it's easy to say "telehealth has a real impact on lives and YouTube for children doesn't", but that doesn't mean eliminating net neutrality here and now is a good choice.