All,
Quite a few persons mentioned have mentioned that cellphones and other means of commercial Internet and communications can be used instead of HSMM; but I must agree with Pedja that the purpose of Amateur Communications is to provide a backup to the commodity utility services for use in emergency - among other purposes. In addition, the Amateur Radio and Satellite services are available for by those who are interested in studying and improving in the radio art without monetary interest. The purposes for the commercial spectrum are completely different than that allocated for amateur use. In the US, it's also unrealistic to assume that the commercial communications infrastructure will be locally available in case of certain emergencies - considering the history of the availability of communications during local and national events.
I'd have to agree with Pedja; in my Section, we are very interested in providing HSMM services at locations we serve in Emergency situations. For example, we would be interested in being capable of VoIP, VideoConferencing, the email of files and/or high-speed (>56k) data transfer. We eventually envision a complete Amateur-only Network that does not rely whatsoever on Commodity Communications for Backhaul. My RACES/ARES organisations (W3PGC and K3ERA) provide services to the hospitals in our county.
I personally find it unrealistic to pay exuberant sums of money for devices that are only useful for infrastructure operating at 1200 baud, or to assume they'll be very useful to an agency such as a hospital or Red Cross station during a prolonged event. Compared to 1200 baud, IPoAC (IP over Avian Carrier protocol - RFC1149) actually becomes more viable - depending on the amount of data to be transferred, the payload and the ability to find other carriers to do so.
http://en.wikipedia.org/wiki/IP_over_Avian_Carriers
73,
Lynwood KB3VWG
-Lynwood