About half of us stay away from the doctor, even when we shouldn’t, because health care costs too much, according to a recent survey by The Commonwealth Fund, a nonprofit organization that monitors the quality of health care. But while you can’t change the complex, maddening system all by yourself, there are a few steps you can take…

Negotiate. If your doctor’s office fee is too high, ask him to give you a rate based on your ability to pay. Patients who request a discount actually get it about 50 percent of the time, according to a recent survey by The Harris Poll. Some doctors, hospitals and clinics may offer a reduced rate if you pay cash. Ask your doctor directly rather than going to an office manager or administrator, who may not have a personal relationship with you.

Take care of yourself. The best way to keep doctor and emergency-room visits at bay? Stay as healthy as you can. You’ll keep medical costs down by being smoke-free, maintaining a healthy weight, eating right and managing stress.

Ask for generic drugs. FDA-approved generics use the same ingredients as brand names, and consumers pay about a third less for them. If you’ll be on the drug for only a short time, ask your doctor if he has samples he can give you for free.

Consider local walk-in clinics. Some national chains and drugstores, such as Target, Wal-Mart, Walgreens and CVS, have opened low-cost health clinics, and there are other chains of clinics as well. Visits generally cost less than $60, but keep in mind that these facilities typically handle only minor ailments like a sore throat or a sprained ankle. But in a pinch, if your doctor’s office can’t accommodate you, you can get prompt medical attention at a lower cost than a visit to the emergency room.

Investigate patient-assistance programs. All the major drug companies offer low-cost or free medicines to qualifying applicants. You can find more information about these programs nationwide from the Partnership for Prescription Assistance (pparx.org), the Pharmaceutical Research and Manufacturers of America (phrma.org) and the Patient Assistance Program Center (rxassist.org).