NEW YORK ( TheStreet) -- Consumer health care spending, specifically out-of-pocket expenses, rose 4.8% last year, to $768. That come from the Washington, D.C.-based Health Care Cost Institute, and it shows the third straight year in a row spending on health products and services is on the rise for Americans ages 65 and under. Overall health care spending rose $181 from 2011, to $4,701, although most Americans see the bulk of that financial burden shouldered by their employers. Outpatient care and prescription drugs fueled most of the spike in medical costs, with drug purchase costs up 3.8% (brand-name prescription drugs rose 25% last year, the HCCI says). Outpatient services spending took a bigger bite out of American's cash reserves, rising 6.5% last year. higher-deductible employer health care plans? here). It's also a good idea to offer to pay cash for doctor and dentist visits. Medical care facilities (even hospitals) hate all the paperwork, and now that the federal government is getting more involved in the health care sector, the need for paperwork could grow. Leverage that by offering cash for a discount, allowing medical practitioners access to a quick payment and less bureaucracy. Another tip: Shop around for prescription drugs, and go generic. A Consumer Reports study shows that Americans can save $749 on major prescription drugs by going generic. Big box stores such as Costco ( COST) offers the best deals, Consumer Reports says. For online drugs, try FamilyMeds.com; the study says the online drugs provider offers some of the best deals on the 'Net.