Semi on-topic, but it's the only way that I use the net to play. We game once a week, and I've set up a room in our house to be the "Gaming Room" (I love having a house large enoough that I can devote one room just to gaming) and in the corner is my digital video camera that is capable of streaming USB output. It has a very sensitive Omnidirectional mic that picks up everything said in the room.
We have a friend who moved about 2 hours away a couple of years back. Recently we have been able to let him game with us by teleconference. I just hook my laptop up to the camera, fire up ICQ, and it's just like having him there. We've also tried using MSN and NetMeeting, but MSN has always had problems getting the audio to work, and netmeeting gives us about a 1-2 second lag (although it allows us to resize the video window so that it is easier to see the player on the other end.) Since he is the only one gaming on the other end, a simple webcam and regular microphone are all he needs to play.
It is fairly easy to set up and works great. I wish we would have gotten it up and running a couple of years ago, rather than finally getting around to it about a month ago.
Edit: A hint for anyone wanting to try this... There is a dice rolling bot for MSN that we use. I usually have both MSN and ICQ up while we game, ICQ for the video and audio, and MSN for the Dice Bot... If anyone knows of a Dice Bot for ICQ, I'd be really grateful to hear about it.