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I would say this is still a consumer level product and can be a good secondary element. It is not reliable enough for serious or dedicated business apllications. IMHO.
The lines ditch out often, maybe 10-20% of the time (seemingly when you have a good prospect on the line) but that is to third worldish countries like Peru, Columbia, at other Latin Americas. Maybe to the UK it is more consistent.
We definately get our value out of it, but would not rely on it in any way.
Properly setup, VoIP is perfectly fine for business use.
The probelm with VoIP and services like Vonage is it's too easy to slap that ATA behind your router and start -- without really knowing what is involved and what you're getting into.
People still don't understand that faster isn't always better when it comes to "realtime" things like VoIP.
I save a fortune and get lots of advanced features -- but I had the advantage of requiring high speed data links at all of my locations anyways, so it was cheap to throw a little extra bandwith in for the VoIP on a rock-solid connection.
My understanding is that you need 90Kbps per line
About a quarter of that, with a high quality codec.
GSM can get it down to about 14kbs.
If you just want telephone numbers in other countries though, terminating to your PSTN line, you don't need to go VoIP. You can take advantage of the services available without actually changing anything at your end.
Your probably using VoIP 50% of the time already, you just don't know it, as it's in use as "glue" between networks and has been for several years.