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We don't have 'circuits' anymore, like a T1/E1 line dedicated setup circuit. We have an approximate bandwidth. Now within some general guidelines you SHOULD be getting what you pay for. I have a 7M down, 400K up which is pretty consistent w/in 5%. I did find that TW did a 'quiet push' and my 7 year old cable SB4100 modem couldn't handle it. So I swapped out the cable modem for a new SB5101, for free and instantly doubled my throughput.
The real issue is not so much bandwidth which is usually adequate - it's latency created by apps that don't play well. Torrents are notorious for hogging up inbound queues in the DSLAM. When you have 20-30 inbound streams to feed a torrent that's what stacks every other app in the wait queue. Pile on enough of them and the DSLAM discards them. This is what causes VoIP chop like you're talking into a fan. It's also what causes 'large' apps to queue up and wait. A 'large' app would be a webpage with multiple simultaneous embedded flash apps. Another problematic app is 'Fasterfox' which attempts to deep prefetch. This can wreak havoc by creating too many fetch commands that pull up too many streams.