Well, to add another perspective, and not to advertise in any way, but our company provides outsourced customer/technical/billing support services. It's intended to be "overflow," for the times when a hosting company may simply not have the resources to provide support, but would still want to keep a means of support available for their customers.
For our part, we require all our people to be based in the United States, to speak fluent English, and to use proper grammar and refrain from "netspeak." By keeping it American, we can enforce any NDA that our clients would want us to sign, and that we would make our people sign. I also find it hard to believe that a customer appreciates it when he or she needs help, the person on the other end can barely speak English. In other words, we have standards, and it seems that many times, outsourcing companies don't. While the techs in India may be very smart, skilled, and all that, it doesn't do any good if our customers can't understand them.