We are still using 2 wire circuits from the Telco for our off site stuff. I work on a university campus, so on site we have our own fiber and copper to use.
Off site, the LEC is as reliable as we can get, short of running our own microwave links.
I also run the PBX, and as we move into the VoIP world, I've discovered that most networking folks have no clue what five nines are, or how to treat systems that carry public safety traffic or even telephone traffic. Things are slowly getting better, but we still have issues where routers will get reloaded in the middle of the day with updates, knocking out service.
On the other hand, as the LEC's evolve away from circuit switched systems, and the old timers retire, the quality of service is dropping. Having to train the LEC techs that show up at our site on how to test their own services is getting to be a common occurrence. I was lucky enough to hire two retired AT&T techs that started back in the 70's under Bell. Those guys know what they are doing and have really helped out a lot. Even though I've been doing this stuff for 20 years, I still learn things from them. Both of them have worked in multiple disciplines, splicing, high capacity circuits, special services, optical systems, 911 systems, etc. It's hard to find people with that much experience these days. Not sure what we will do when they retire.
Not sure what's going to happen as the phone companies "evolve". Customer expectations are dropping as we use more and more IP services. I can look back over the last 15 years and confidently say that I never had my POTS service go out of order, not once. My DSL goes down at least once a week, and the ISP thinks that is totally acceptable. My cell phone works most of the time, but not always, and that is also deemed acceptable.
I'm sure IP and RoIP will take over, but I really hope that reliability improves. Leased dedicated fiber strands might be the answer as prices come down. I think agencies that are fortunate enough to have their own fiber networks are in the best positions. Still, it's really hard to beat the simplicity and reliability of a well built copper cable plant.
I guess I just dated myself....