but it's not the last mile that is the problem.
We've shown that ISPs can handle the last mile easily enough. I've got friends that started (and sold off) their ISP business. I've got one now that's doing wireless (he built a tower on his land) because he couldn't DSL/Cable for high speed and he needed it. So he had them pipe T1 to his place and put up a tower and provide ISP service to neighbors offset the cost.
The trunks are the issue. The people behind this are MCI, BellSouth, AT&T etc who own the trunks. They do have a point -- the VoIP is going to eat their regular trunk business (which is where their bread and butter has been) in the couple of years.
And I still say that the content providers can (if they're brave enough to do it) cause far more havoc for the trunk owners than vice versa. *I* have switched services (from Cablevision to DSL) because of poor access. I've got a friend that's switched twice.
And with services like Gmail and others...the cost of switching (not actual dollars, but the pain involved) grows less each day.
Google et. al. are worried. But I think everyone has been looking at this wrong.