Not much. It's as bad now as it was a decade ago.

In other words, about as good as gmail but with better control over false positives.

For me, Gmail solves the spam problem. I don't even remember the last time I've had a false positive or a piece of spam that made it to my inbox.

My entire family uses Gmail (our domain is hosted via Google Apps) and as far as I know, it's been very close to perfect for all of us.

Well, do you really check your spam folder all the time? There might be false positives that you miss.

There are also false positives than never make it into your spam folder - that just get dropped silently. (I have a friend who's company's GSuite email _regularly_ does this...)