I think that "dumb pipe" is the right answer, with regional monopolies for certain classes of service or public/private partnerships. We achieve a lot of advancement with the death of AT&T, but the modern regulatory regime allowed for the rebirth of something that looks a lot like the old AT&T.

The issue with this sort of infrastructure is that it is very capital intensive to build and maintain, and require that the companies invest in real estate rights (telephone poles, utility trenches) that are powerful bargaining chips.