ANS. First, we notice that the one who initiates any practice of the promise to save the sick in James 5, is the sick one himself. He must then call the elders of the Church. It may be difficult to know who these elders are in the divided and weak state of the Church. Prominently, faith must be there, first in the one who calls and then in those who, as overseers or elders, have a responsibility to discern the case and whether to act or not to act. The promise is that the prayer of faith will save the sick. The power is from the prayer and not any miraculous gift of healing given to any persons.
As to the second question we say, yes, it is a reflection on the state of the assembly. Also perhaps there are few who have faith to act according to this provision.
Ed.