I probably can't "help", because I think so much of the answer is location-dependent.
Likewise, I'm not yet on the HD program (I've had too much other cool stuff to buy before a new TV).
We had Comcast cable for many years. When we moved a few years ago, I got a good deal on DirecTivo and have been extremely happy with the service and value. I noticed a definite improvement in signal quality over analog cable for SD signals. The service has only been interrupted a couple times during heavy snow and the PVR boxes have been trouble-free. They carry the Fox sports affiliate and the local channels.
We've always had DSL, which improved markedly when I ditched Qwest as the ISP. I still have to pay them for the line, but using an independent ISP was a great choice for us.
