Each city awards a franchise to one cable company. Then there are sometimes smaller companies that provide cable building by building. And of course you can get satellite if you have a clear view of the southern sky in your residence.
I heard many times in the show about cable TV, it sounds like monopoly, is there only one company per city, or how it works??, Is comcast and Time Warner the only companies?
In my city I used to have the choice of 5 pay tv companies, Sky (dish former DirecTV)), Televicable, Telecable, Mas TV and Maxcom, now after adquisitions by bigger companies there are only Megacable, Cablecom, Sky (dish) and MasTV still I have choices.