The nearest cable box is next to our neighbor's driveway. The phone company has fiber to their box in our other neighbor's yard.
There's enough competition to keep price inflation mostly at bay, but there clearly isn't enough to convince the ISPs to invest in the equipment that would be able to give us connections that are four times faster. Efficiency doesn't have a lot to do with it. For all practical purposes, our local ISPs aren't spending any money to improve service in areas that already have some service.
I don't buy inefficiency. They're selling it at this speed for this cost because they can, just like cell phone companies. Which from a business standpoint makes perfect sense, but it's at the cost of screwing everyone else. Since significantly better businesses / strategies clearly exist if it's just a sign of business incompetence, why haven't the successful ones, say in Japan or Korea, migrated over here and decimated the market?