Yeah, SBC rates for the leased lines can kill ya, but MW doesn't have to be expensive and doesn't require that much in service. As long as its PM'd once in awhile, life is good.
You can even run in the unlicensed spectum for most applications. Biggest problem with MW are making sure you have a good path. If you have that, MW is the way to go.
Right now we are looking at an IP based approach for 6 tower sites, but I think that's getting things a little too complicated. We have the fiber to do it, but the MW has been so reliable and we control it, why wait hours for a service tech from the telco when we can hit the shelter and trouble shoot (and hit reset) and have things working in 20 mins?
BTW: I am using old ass Motorola Starpoints and never had a problem. My newest MDS digital link though gives me headaches all the time (damn -110db RX alarms!)...but usually with the power supplies. Like the box, like the features but something I would not buy again (not that I really had a choice the first time....) Each dish is carrying at least 10 channels, some 14. Can't beat free! Only reoccuring costs is electricity and the PM.
Simucast is a nice way to go, but is expensive as mentioned. GPS clocks are cheap, but its the high stability osc's that cost the mega cash in order to have that a nice tight signal. Things have to be perfect, the but the results are outstanding. That's my current project...getting the county on a six or seven site simucast conventional or VHF trunked. Either option is expensive, just the 2nd one is more....but would take care of quite a bit of problems. Its just getting the elders to open the wallets.