Where I live qualifies as "the boonies", almost. For years the only high speed choices were either a satellite connection or paying to have your own T1 line put in. About five years ago, a line-of-sight wireless provider moved in with 1 MB/s rates [haven't changed!] and the majority of internet users in my 2,000 person town switched. Then, Embarq started offering DSL (a much better option), and that split the difference and the rest of the population generally jumped on board.
Now the only dial-up provider left is Terraworld, an EarthLink reseller, I believe.
Personally, we just got DSL late last year, and it was 1.5 MB/s. It was wonderful for us after having been on 56k and then 44k for so long... but thankfully we upgraded to 3 MB/s earlier this summer. Still not stellar, but it sure makes those iTunes movie downloads go a little bit faster. As of now, the fastest connection in my part of the world, consumer-wise, is a 10 MB/s DSL connection.