The Problem isn't the inter-switching connections but likely the 'last mile'
Bell Canada, some 20 years ago, cabled a fairly large sub-division in North York, Toronto with fibre optic cable. Then the Neanderthal cable company came along later and laid co-ax into each of the homes.
For around 10-15 years the Canadian telco's have been running high-capacity fibre in to new highrises and, with changes in the law, the former telephone only and cable TV only companies have been able to compete by offering all forms of communications.
The challenge will be forcing these two industries to share facilities in the 'last mile' to customers premises.
Of course, there remains the question of what terminal equipment will be used, important since telco's abandoned the home telephone 'instrument' business some decades ago.
Here in VietNam, following the defeat of the Americans in the American War in VietNam, European companies cleaned up by running fibre cable up and down the length of the country (and crossways, too) with digital switches completing the backbone. All communications is via fibre. Satellites are used to feed TV to remote areas.
Digital subscriber lines completed the system to homes in major towns but in more remote areas telephone lines remain.
Both my office in Buon Ma Thuot, as well as my wife's two hotels, located in cities with 400,00o+ souls, are fed with 200Mbyte fibre cables. Our summer house, midway between between BMT and Da Lat has 30 Mbyte InterNet - there are only 20 odd houses in the hamlet who also have similar speed service.
Interestingly, in Ho Chi Minh City, the competing communications companies have joined together - easy to do when you have a government such as ours - and my new apartment has a terminal which can supply digital landline as well as three InterNet feeds from different companies and two digital HD television signals. The service options are selected by a small matrix of selector pins.