Which platform? Most Mac enthusiasts are diehard iChat fans. I use iChat to videochat with family (1,200 miles away) all the time. Works like a charm, you can get encrypted chat, and hardly ever have any issues with bandwidth, bugs, etc. (Minus the bugs that were rampant when Apple implemented QOS packets with the Tiger release, which has now been corrected.)
If you do not own an Apple, then AIM offers videochat. The only real advantage to using AIM is that a lot of people are AIM users, making it better able to communicate with your friends. I don't think AIM offers the best videochat program though.
Maybe some of the PC users can comment about the various programs used on their side of the spectrum.