I've been using SKYPE for about a month now. I live in Egypt and my family is in the US. It only costs about 2 cents a minute to make calls and the connection is very clear. I do sometimes have trouble with brief moments of interference (we can't hear each other). I'm wondering if I had a broadband connection instead of dial-up if that might be better.

I'm very happy with the clarity-- I use a Plantronics USB headset. This is my first experience with VOIP so I don't have anything to compare it to but I would definitely recommend it.