Akamai is firstly about LARGE numbers of hits at certain times.
I worked for a company that expected a surge of hits and bought and paid for Akamai to come in. Turns out we never needed them because we sucked.
What that experience told me was that Akamai was mostly for Victoria's Secret ads during the Superbowl.
They explained their strategy to me, and having caches around the outside of the net is certainly a good thing.
We weren't streaming video but we had an MMO and it's sister website up.
Akamai exists at least partially to take your heavy hit and spread it out, because you did something PUBLIC (Superbowl Ad is the best analogy).
I feel that they are good for Net Neutrality in the terms that if YOU advertise and cause a MASSIVE hit, you better be prepared for it.
But everything else is bull-oney.
First post and died at the end sorry.