Suppose there weren't any official monopoly grant from way-back-whenever to your existing local telco and cable companies. There would still be a de-facto monopoly or duopoly: The easement permitting process, currently entirely blocked due to the monopoly grants, would exist, but as a sham... with the (mono|duo)polies coercing city politicians not to let upstarts dig up roads or string new cables. I've lived in a city with lots of fiber being put in. It's a nuisance, and without vocal public support it's easy for entrenched ISPs to argue that the nuisance isn't worth the increased choice, particularly in markets where there is already "competition" between one [horrible] "cable" provider and one [horrible] "telco" provider.
How about this? No monopolies at all. If I want to run cable and I get the easements, I should be able to...