Well my provider uses Google for their e-mail addresses, so if I really wanted to get one I could have firstname.lastname@example.org and access it via Gmail.
My mother still uses dial-up Internet, primarily because she had a hard enough time getting all of her acquaintances (most of them aged admittedly) to get her simple address (email@example.com) correct in their address books to begin with, and getting them to update it correctly to the new address would be a craps shoot. This is the biggest reason she still uses dialup, and will likely continue to pay $9 per month for it, despite a wireless bridge I'm setting up to her house a block away so I can share my broadband with her.
Thankfully 12+ years ago I was forced to change e-mail addresses 3 times over as many months due to ISP acquisition turmoil in my area, so I went to my own domain. It was rare for individuals to do that back then, but I have zero regrets, and it has made it very easy for me to switch ISPs subsequently. Amazingly enough I still get the "what is your new e-mail address?" question occasionally after a move.