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You can do everything Google Voice is offering already but maybe they'll be able to simplify it enough to make it mainstream. I've made calls through my cell phone over the internet and they're not bad, although the delay is noticeably increased. (Ever try a cell to cell call between phones in the same room? More delay makes it harder to have a normal conversation - gets too long and you gotta say "over" when you're done so the other person knows they can talk.)
It'll be interesting to see how much they're gonna charge for international calls. As it is now, unless you're talking on an internet-to-internet connection, the VoIP providers are more expensive than other dial-around carriers (like calling cards).
Google voice is great if you plan on doing international calling or you need a unified calling/voicemail system. As for if you should have it, it depends on the type of caller that you are. If you have multiple numbers and need to bounce people back and forth its great, but as a prepaid caller I don't think you need or should have the service.
As to your other question an SMS is a text message. If you don't have unlimited texts, don't bother with Google Voice. Sure you could turn off text notifications, but what's the point of using Google's voicemail feature if your not going to take advantage of the transcribed messages?
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