Here in the King County Metro area, we are beholden to Comcast, with no choice for alternatives. Our prices are fairly rediculous. Not too far away, in Tacoma, prices for the exact same services are roughly 50-70% of what we pay, and service is very good.
Why?
Because Tacoma built the Click! network as a competitor to Comcast, then AT&T.
Competition, it's the only way to go.