The exception to the 'rule' of rural areas and fiber service, is in Vermont currently. The state is split into a couple of Telcos for hard line and cell service. We happen to be on Vtel/Vermont telephone. It provides 1Gig, (A billion bits/sec) service to all it's rural customers, and there is a bundle available for TV and phone; though for now I'm sticking to the fiber as replacement for their DSL service, which promised a lot but tended to deliver a little, due to being far from the 'switch'. As they make the underground copper pair lines obsolete, they get less and less service repairs to keep them running right.
I use Dish for TV, and because I have it, things like Netflix are available.
It is also true that in this same rural area Comcast brought cable internet availability, BUT it won't get to my house, a mile from the local highway up our dirt road. I think this is because with Vtel running fiber Comcast has no incentive to string cable in the same area. Wouldn't want them anyway; used them in CT and they are USELESS.
I can't believe how crappy the services available to most of the US really are considering our ability to do technological tasks well if we choose to. It just blows my mind that these companies, like cable companies, suck so badly at making things work for reasonable money.