Drive 10-20 miles, and you'll be in areas where AT&T decided to sell the lines to a bankrupt telco. Looking at the lines in those areas is entertaining. The telephone poles were installed by some ancient secret society named "GTE", and now have 20 degree bows. When lines loosen up and block traffic, the usually just tie them up on to some nearby tree branch.
If you look really carefully, you'll occasionally see fiber points of presence dangling precariously from this mess of caution tape and guy-wire.
It's not all bad news: I know of communities outside of telco right of way that managed to tap into one of those.
Last time I heard they were debating between 1 gig symmetric to each home or paying a couple hundred bucks (one time) per house to get something comparable to what you'd expect in Tennessee.
It's definitely a problem with incumbent monopolies.