Health is one of the top three issues for Australian voters, and the lack of focus on an ''under pressure'' system has angered consumer groups and peak medical bodies, while at the same time confusing voters.

Australian governments combined spend more than $130 billion on healthcare annually.

In the US, an ageing population, expensive technological advances in medicines and treatment, and the pull between private and public hospitals have led professor of healthcare policy at Harvard Medical School Michael Chernew to warn the country faces a ''fiscal Armageddon'' as healthcare spending grows.

While the problems facing the Australian public health system are not as dire, we still face challenges, with government health spending growing 74 per cent over the past decade. And with both parties ruling out tax hikes, there is more pressure on how to divide the available funds and tough policy choices to keep a lid on costs.

Chief executive of the Consumers Health Forum of Australia Carol Bennett says Australian healthcare is increasingly divided into those who can afford to pay and those who cannot - an imbalance requiring urgent action.

''We do not have universal healthcare in the country any more unless you go to an emergency room and need surgery. Even then, there are long waits,'' Ms Bennett says.

She says the average Australian was spending $1000 on out-of-pocket medical expenses each year - a figure that puts Australia at the wrong end of the global list.

''What consumers want to hear is how they are going to manage that, since cost of living seems to be such a priority for both parties. It's hard to go past healthcare as a part of cost of living issues, but it seems they [politicians] haven't begun to turn their attention to it.''

Prime Minister Kevin Rudd used the phrase ''cost of living'' 14 times in his press conference on Monday. On Tuesday, Opposition Leader Tony Abbott used it four times.

It is a situation Ms Bennett does not understand. She says: ''We are already seeing two tiers of system for those that can afford care. The out-of-pocket costs is one but there are rationing systems in place that mean that people who can least afford care and are most likely to experience illness are missing out.''

She says people who can afford to pay are bypassing public hospital elective surgery lists by going to a private hospital.

(The term ''elective surgery'' is also a misnomer as it catches anything that is not emergency surgery, including surgery for broken bones.)

Canberra's two major hospitals are failing to meet targets on waiting times in their emergency departments and with semi-urgent elective surgery.

The ACT government set a target to treat 65 per cent of patients within the clinically recommended timeframe this year - the lowest target Australia-wide - as hospitals work towards reaching a nationally agreed figure of 90 per cent by 2015.

Calvary Hospital came closest in the January to March quarter, treating 63 per cent of patients, an increase of 4 per cent from the first quarter last year.

But Canberra Hospital's figures decline from 55 per cent in the first quarter of 2012 to 53 per cent in these latest results, released by the National Health Performance Authority on the MyHospitals website.

In the major metropolitan hospital category, which the Canberra and Calvary hospitals fit, the national average of patients treated within four hours for the quarter was 60 per cent.

Ms Bennett says more funding for public hospitals and more money for surgery would help those figures and give disadvantaged patients such as the elderly and indigenous Australians better care.

''Waiting times are a really good indicator and what we've seen in recent times is that waiting times for elective surgery have really gone up - particularly in disadvantaged areas where people are waiting 11 days longer for elective surgery than a well-off suburb,'' she says.

But she applauds the government's decision to speed up price disclosure on PBS medicines: ''It means the government will only play the price pharmacy owners pay to drug manufacturers for PBS medicines - it's an $840 million saving to government.

''That money is freed up for new treatments on the PBS, but it also means that a whole lot of drugs' prices will be cut. It's a very good move for consumers, but it doesn't go anywhere as far as the government could be going on this issue.''

Director of the Australian Centre for Economic Research on Health at the Australian National University College of Medicine Jim Butler says the main parties' agreement on vast tracks of healthcare policy was stifling debate. ''I don't think health has featured largely in the election so far and I think it's unlikely to feature in the future,'' he says.

''The differences between them are more at the margin of what's going on rather than large-scale changes.''

He says neither party is ''brave or courageous'' enough to make large changes.

Remember Sir Humphrey's words in Yes Minister that ''controversial'' only means ''this will lose you votes''. And ''courageous'' means ''this will lose you the election''.

''It's a reflection that a lot of Australians are by and large happy with Medicare and the national insurance system as it is, so trying to change it in any way would be a brave move,'' Professor Butler says. ''The Coalition aren't coming out with any major reforms to the structure of Medicare, in terms of the aged care reform the government has just implemented … the opposition hasn't given any indication at this stage it will overturn this model.''

But president of the Australian Medical Association Steve Hambleton says Australians have not felt the full effects of budget cuts announced by Labor in the 2013 budget - cuts he labelled the ''Four horsemen of the Apocalypse''.

Labor wants to freeze indexation of the Medicare rebates for doctors for eight months, saving more than $600 million. It plans to increase the extended Medicare safety net threshold to $2000 and phase out the medical expenses tax offset as well as crack down on doctors' work-related self-education expense tax deductions of $2000.

''There is a lot in that budget that needs to be undone. Medicare needs to be supported so people can get access to GPs and primary healthcare,'' Dr Hambleton says. ''It shifts the cost on to patients. It goes for all - doctors, specialists - everywhere where there is a gap it will get bigger.''

But on average, a 50-year-old now is having more interaction with the healthcare system than 10 years ago - seeing doctors, having more tests and operations, and taking more prescription drugs. And it means life expectancy has been rising rapidly since 1970.