Few things cause more heartburn than the fear of getting sick and being unable to pay for medical care. That's why health insurance was invented. But now the cost of health insurance itself is becoming unaffordable.

While neither health care nor insurance is likely to get cheaper, there are things that can be done to make insurance more affordable. And there are ways to get treatment if you don't have insurance.

In many farm families, for example, one spouse may take an in-town job in part because it offers health insurance. If that's not an option, consider a high-deductible catastrophic policy. These no-frills policies, with deductibles of $2,000 and up, are more affordable than policies that cover everything.

If you get seriously ill, catastrophic insurance may stave off bankruptcy, says Jack Thomas, director of the Family Practice Residency Program at Pacific Hospital in Long Beach, CA. Thomas is a frequent media commentator on health matters and host of the TV series, “Dr. Jack's House Calls.”

Insurance brokers and the Internet are two ways to search out the most affordable insurance. But look before you leap. Check out the track record of any company you're considering. The rising number of complaints against insurers suggests that not all companies deliver. If you do buy insurance, remember that federal law allows tax breaks for many self-employed individuals who pay for their own health insurance.

If you still can't afford insurance, there are avenues to obtain lower-cost health care. For example, Congress passed the Healthy Family Act, which gives millions of federal dollars to state governments to help families without insurance pay their children's medical bills. However, many states have failed to publicize or properly implement the program, so it may take some work to find out more information.

Many hospitals will negotiate a lower fee structure for patients who can't pay their bills in full. While you can try to negotiate after the fact, it's better to work out a payment plan in advance if you know you'll require hospitalization and don't have insurance to cover it.

“Be proactive,” says Thomas. “Go to the hospital's business office and ask what you can work out, such as a reduced-price payment plan.”

Free clinics can be found in some cities, and many areas have reduced-price teaching facilities where doctors go to meet their residency requirements after medical school.

“I'm a director of a teaching clinic,” says Thomas. “Our fee scale is much less than you would get at a private facility.”

(Check your area for reduced-cost dental programs as well. Dental schools may be one place to inquire about the availability of low-cost dental care.)

If you have an emergency, remember that, under federal law, hospitals are required to treat emergencies first and worry about billing later.

“Neither profit nor non-profit hospitals can turn you away if you think it's an emergency,” Thomas points out. “If you have an emergency, go to the nearest hospital, or call 911 and emergency crews are supposed to take you to the nearest hospital.”