Health care is expensive, even for those with insurance. My treatment with the breast cancer drug Herceptin cost $5,000 every three weeks for 52 weeks. Insurance paid 80 percent; I was responsible for 20. That's $1,000 every three weeks. Not exactly affordable.

What many of us don't know is that we can play an active role in cutting our health care bills. We can shop around for everything, for example. Before filling a prescription, consider comparing prices offered at mail-order and online pharmacies with those of larger retailers. You may even find that mom and pop shops offer competitive rates since they can set their own pricing. Don't forget about generic drugs too. Ask your doctor if a generic version of your medication is just as good as a brand name drug. If so, go for the price break.

Did you know that lab work is more expensive if you get it at a hospital? Ask your doctor for other trustworthy locations and save a few bucks.

It is said that 79-year-old Leonard Kulisek had not suffered any major illness in the years before his unfortunate death, except he did have a prescription for his gout. The Walgreens pharmacist who filled Kulisek's prescription was working under the influence of OxyContin and hydrocodone. Instead of gout medicine, the bottle was filled with insulin pills. The next day, Kulisek slipped into a coma, and for the next 22 months suffered a series of health issues before he died.

The pharmacist admitted to being addicted to painkillers for eight years, and had stolen over 86,000 pills from the pharmacy where he worked. The jurors held Walgreens responsible for failing to catch the drug thefts or notice that the pharmacist had an addiction problem. Walgreens must pay $31 million dollars to the Kulisek family. Walgreens plans an appeal.

Medication errors can occur for a number of reasons. What can you do to avoid medication errors? According to Rx for Safety, the most common reasons that errors happen are:

• Incomplete information about a patient.
• Incomplete information about a medication, such as warnings or side effects.
• Poor communication regarding a prescription such as illegible handwriting, confusion between similar drug names, misuse of zeroes or decimal points or inappropriate abbreviations.
• Lack of appropriate labeling on the drug container or pharmacy shelf.

Before you leave the doctor's office, look at the written prescription. Can you read the handwriting? If you cannot, the pharmacist might have a problem reading it accurately. When you have your prescription filled, ask the pharmacist to answer any questions you might have regarding the medication. Check to make sure that printed literature is included with the prescription detailing information about side effects and proper dosages. On the side of the prescription bottle is a label that describes what the pill looks like. Check to make sure the description of the pill matches the pills inside the bottle.

For more information on additional safeguards, read Avoiding Medical Errors at RX for Safety.

A study completed by the Institute of Medicine of the National Academies has found that at least 1.5 million people are harmed as a result of medication errors each year.

The panel recommends steps that health care organizations, government agencies, and pharmaceutical companies can take to reduce the level of medication errors. The incentive for these combined groups is a saving of an estimated $3.5 billion dollars now spent each year by hospitals on the medical costs attributed to treating drug-related mistakes.

Several of the recommendations for health care organizations, government agencies, and pharmaceutical companies include standardization of the text and design of medication leaflets so consumers can understand them; and the creation of a website by the government that provides a comprehensive and easily understandable source of educational information about drugs and to fund a national telephone line for people who don't have internet access.

The panel also offers suggestions to patients in keeping them safe where medications are involved. Patients should keep a list of all medications and all non-prescription drugs taken, as well as all vitamins and herbal remedies; review the list with their health care provider; and ask questions and expect complete explanations before agreeing to take a medication.

The Institute of Medicine of the National Academies has published What You Can Do to Avoid Medication Errors, as a fact sheet for patients, available as a PDF document.