Whether or not viable alternatives exist, those alternatives don’t magically change org structure, office politics, budget, current business priorities, etc.
Bottom line: many people managing exchange don’t have the luxury of evaluating this problem in terms of alternatives.
People used a few different groupware solutions, worked with bespoke IMAP installations on Linux servers, or (the vast majority) had on-premises Exchange servers running locally. It all required lots of tech wizardry, tinkering, duct tape and hope.
It was a long while before we had turn-key solutions, and you needed actually knowledgeable folks running your IT operations, and nothing was as fully integrated or cheaply available as Exchange Online.
a.k.a. i think you're missing the point. It's ok. You want knowledgeable people running your key infra. Outsourcing that to a company that doesn't respect privacy seems to be shooting oneself in the foot.
