On the web side, you can mitigate some of that by having the browser do lots of link preloading. On the other hand, gaming is right out, and VoIP is likely to be not much fun either. But if you're out in the sticks, what choice do you really have?
Believe it or not the latest generation of online games are still optimized for 56K dialup. If they could use the fast but high latency connection to download patches and just play using dialup their experience would not be all that different than cable modem users. Yes there is a difference but it's not as great for online gaming as it would be for downloading or streaming.