insane: I'll throw something in here, if you are getting even slight packet loss you may still get respectable speeds locally but terrible speeds internationally, so even good national speeds may not tell the whole story.
I had just this problem a few weeks back after fiddling with some wireless networking settings, took a while to narrow the problem down given my good national results.
Ah this is a good point. What are the usual suspects for packet loss on a DSL connection?