AT both the Federal and ACT elections, health is shaping up to be a key election issue.

Federally, the Coalition government has made a rod for its own back by attacking family doctors in a manner that has turned long-term allies into antagonistic forces.

Locally, the ACT Labor government will attempt to use its health achievements to divert attention from the Liberals’ preferred issues of light rail, increases in rates and Labor’s close relationship with the unions.

The conservative government under Tony Abbott and then-health minister, Peter Dutton, attempted to introduce a compulsory co-payment to Medicare. A vigorous attack by almost every non-government organisation involved in health made them back down from a poorly thought-out policy.

An alliance of the Australian Medical Association with the wide range of health groups effectively put the government on the back foot in primary health care policy.

Instead of seeing the writing on the wall, the government took a back-door approach to achieving its aim. By freezing the level of payment to the primary healthcare providers, the conservatives have effectively forced general practitioners to do their dirty work. As costs go up with a static payment, GPs will not be able to afford to bulk bill patients. One by one, they will be forced to introduce their own co-payments.

The government was also recently forced to back down over changes to pathology payments that would have seriously disadvantaged cancer patients. Whether by stealth or direct action, this ideological push will be strongly resisted by the same forces that embarrassed the government on its initial introduction.

A universal health care system is one that provides appropriate access to the community without distinguishing on the grounds of ability to pay. The conservatives, who have largely railed against Medicare since its introduction by Gough Whitlam, have yet to really grasp how widely Medicare is understood and adopted by Australians across the socio-economic spectrum.

Hospital funding is yet another weeping sore for the conservatives.

The government has attempted to argue that as the long-term commitment for increased spending on hospital funding was not in the four-year Budget, that it was not real – and therefore the changes are not cuts. They have been hoisted on their own petard. The decade-long increases in funding for the military clearly illustrate that commitments can be made beyond the Budget period. They cannot have it both ways.

My own organisation, the Public Health Association of Australia, has identified prevention as a key element for governments wishing to demonstrate a long-term vision.

With around just two per cent of health expenditure going into prevention, it is fair to say that governments are only paying lip service to the key areas of health protection, prevention and promotion. Action has been taken on tobacco. Little has been achieved on the harms associated with alcohol or junk food.

Climate change is a serious health issue which should provide an advantage for Labor and the Greens. Despite a hope for a changed approach in this area, the Turnbull government has been as disappointing on this issue as the Abbott government that preceded it.

Oral health may prove another election issue. The conservatives have resisted the previous Labor call for a system of “denticare”.

The final nail in the coffin of the Liberal government on health is its string of broken promises. When Tony Abbott went to the last election promising “no cuts to health and education” and then moved rapidly to break those promises, he not only undermined trust in his own party and his coalition partners but also generally undermined trust in the political process.

Michael Moore was an independent member of the ACT Legislative Assembly (1989 to 2001) and was minister for health. He is the CEO of the Public Health Association of Australia.