With Qwest in Washington State, the only way of getting out of having to pay a monthly fee for long-distance access is to sign up for something called "Managed Long Distance", which prohibits you from using 10xxx and 10xxxxx numbers and international dialing. You're allowed to make domestic long-distance calls, for which you are charged $.18/minute(!) and are cut off when it reaches $20.
I got fed up with paying $5+ in fees in order to make less than $1 worth of long-distance calls a month. I either use my cell phone or Skype for long distance calls (my residence is in a weak/dead zone for all the cell phone carriers) and Skype for international calls.
-- Mark --