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You run fiber to the home and gigabit ethernet or whatever internally in the premises. All your other complaints re: cost and etc aren't really an issue for last mile consumer grade fiber.
I have seen installers run a fiber drop cable across from a power pole, bring it down an outside wall , then staple it to joists under a house, cleave off the end and stick a mechanical splice on it, bang it in the power meter, all good, plug it in the fiber modem, good to go in less than 20 minutes. All this stuff uses standard components and technology that's been available for 10+ years now.
It's probably the standard "last mile" half assed solution where they decide to use existing phone lines and VDSL from a box down the street instead of biting the bullet and running fiber.
This is how it works in the UK too. I've got Fibre To The Premises (FTTP), and the installation was pretty much exactly as you described.
This is common in Upstate NY Cities. In fact Earth Link still owns some of the dark fiber and backbones.