North america seems to lack neutral peering exchanges.
We ISP's in Europe are able to connect directly to the content networks and other ISP's at the nearest neutral peering exchange. Peering exchange members pay port charges based on the size of the port they require, not a charge based on traffic balance.
In terms of our company ( an ISP) this means we get ~70% of our peak customer traffic delivered directly to us from content providers across neutral peering at INEX.
This is a model that makes sense when you consider traffic flows between ISP's and content providers. But it's hard to deploy in existing markets that have evolved without the concept of neutral peering and it 'may' deprive Tier one transit providers of revenue by creating more direct connections between content and consumers.