I think you're confusing tiered access to the internet versus tiered access to specific websites.
No, that was exactly my example. In #1, there's a remote surgeon connecting to the robotic surgeon service at the hospital. The hospital should be able to ensure that anyone connecting to their service (i.e., accessing their remotesurgery.stelegius.com endpoint) gets priority over other traffic.
In #2, the example is that the user gets access to Facebook, but not to hackernews (unless they pay extra).
I think the example is contrived, not every average joe is going to connect to 'remotesurgery.stelegius.com' and perform a surgery. So if a hospital wants a stable , high bandwidth , high QoS connection for 'remotesurgery.stelegius.com' they can do that today with any ISP (think MPLS back hauls). Now the doctors that want to connect to 'remotesurgery.stelegius.com' and perform surgery can also do that by getting the same high QoS service that sometimes can even directly connect these two set of end points.
No, that was exactly my example. In #1, there's a remote surgeon connecting to the robotic surgeon service at the hospital. The hospital should be able to ensure that anyone connecting to their service (i.e., accessing their remotesurgery.stelegius.com endpoint) gets priority over other traffic.
In #2, the example is that the user gets access to Facebook, but not to hackernews (unless they pay extra).