I agree, I actually have those set up, though they don't always work for items. Also the target-selection is fairly short range (which is probably a good thing). For those longer-ranged and more specific targetings, the mouse simply works best.
However, the auto-target and 'next target' keys I have set up work superbly in combat - I only very rarely kill passing rabbits by accident.
Be Well!
Fireheart