The last mile is really a logistical problem. The current US system is quite problematic. In many cases whoever owns the last mile provides the service and you basically have no choice.
In contrast, I like the German system. Whoever owns the last mile, is forced by law to lease it at a reasonable price. The result is that you have real competition with dozen of telephone, internet, cable, gas and electricity providers. This is an almost perfect win-win system. The people owning the last mile infrastructure have an incentive to keep it running and upgrading it or else they will lose their income (penalties, incensed fees for better service, government subsidies) and the service providers can reach a large volume of people. This only mildly fails for rural areas, but here subsides are used to alleviate the problem. The other mild problem that established players (e.g. Deutsche Telekom) can rest on their laurels of existing infrastructure and provide crappy and overpriced service, but fixes itself in the long run.