Well the pipe is replaced fairly frequently because people steal it, the dot takes it down, it falls out etc.

So no, not really.  Also the water is constantly flowing through the pipe, so there's not much room for bacteria/mold to collect and grow.

Unlike our house pipes that can contain  coliform fairly easily.

I'm not a fluoride fan, because I feel like health benefits or not, the government shouldn't be adding things to our food/water - what we put in our bodies should be our choice.  If they were putting a few ppm of whiskey in there instead and telling everyone it's beneficial to all, would we still be happy about it?

As for the pipe, just because you don't feel the need to stop there doesn't mean you need to have contempt for those that do.

Live and let live.