I lived in a rural area where there were no options. Cell service was spotty at best, no cable or DSL either. Someone decided they wanted to make money and setup a high power wireless network and carried that signal nearly six miles from town to distribution points. Could get around 2mb which is way better than anything satellite has to offer.
All you need is one point to get the signal to and distribute it beyond that. Not sure why some rural telco's or even investors haven't even attempted this in many areas. One antenna on a tower can service a pretty good area without lines being run.