Calling for Hotfixes --> Don't be scared
If you call PSS for a hotfix, i.e. the datagrid accessibility one, you will not be charged. It's even an 800 number ... that makes calling for this hotfix completely gratis. So, rather than complaining about having to pay for this hotfix (or any other one), read the little note in every KB that mentions a QFE:
Note In special cases, charges that are ordinarily incurred for support calls may be canceled if a Microsoft Support Professional determines that a specific update will resolve your problem. The usual support costs will apply to additional support questions and issues that do not qualify for the specific update in question.
This is a special case. If you call up for a hotfix, and you describe the problem you're having, i.e. “The datagrids in my asp.net pages aren't compliant with accessibility standards”, not only will they give you the fix, but they won't charge you either!
EDIT: Paschal L points out that a call to PSS is not free where he lives.
EDIT 2: The reason you have to call for these things is that they're not tested as throughly as a service pack, or a full software package. Therefore, limiting their distribution will also limit how widespread a bug can be. An example of this testing is that the people that make the hotfix will often have whoever calls PSS and identifies a bug test the fix. There is no beta program, or something of that accord.