Is there some history here that I don’t know about? I’d be pissed if my doctor charged me $200 a year just to keep being my doctor. I would soon have a new doctor.
If the OP has insurance through work, it’s an HR matter. It’s possible the doctor’s contract with the insurance company forbids fees like the OP is complaining about.
Also, I just realized a fair amount of the practice’s patients are Medicare clients so I’m beginning to think its income stream needs to be replenished by younger suckers, erm, I mean clients.
It’s entirely possible that decreased reimbursement rates from Medicare, Medicaid and even private insurance means he’s having trouble paying his staff, rent, utilities, etc. Instead of closing his doors for good and leaving those patients without a primary doctor he is asking that the patients make up the difference.