Indeed tall buildings are a factor, but location is more important in that you're line of sight to the broadcast antenna. There were big swaths of folks who got decent OTA before our Towers fell, broadcast antennas moved to the Empire State building and many lost. Satellite issues involve line of sight to the bird AND many buildings who will NOT allow plain old tenants to externally mount the small dishes.
There WAS a second cable company (RCN) but they totally stalled any build out because they ran out of money and couldn't raise any additional capital. For some unknown reason, they seem to still be operating, but only serving the very limited number of buildings they hooked into 10-15 years ago. Part of their issue was being totally dumb, their initial approach was that a building HAD to of 100% for their services, you had NO CHOICE of anything else.
BTW, I've read posts from guys in rural areas of rolling hills that have issues with OTA as well. I've anecdotally heard of folks in such deep valleys that satellite can't really get into (I found out Direct's bird is about 30 degrees high so it's easy to conceive an area where it can't get to).
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