U.S. health care is gaining increasing notoriety. Information and misinformation about the state of the U.S. health system, including impacts of proposed changes, are being disseminated daily. Political intrigue is increasing. Potential impacts of health care policy decisions on the 2018 and 2020 elections are widely discussed. Anxiety is increasing among voters, politicians, the health-challenged and the poor. A review of some facts should provide some clarity.

First, the U.S. health system is no longer the envy of the world. U.S. consumers pay more than any industrial country in the world for health care by a large margin. The average consumer pays more than double the average of OECD (Organization for Economic Cooperation and Development) consumers, which are primarily industrial countries. For the large expenditure on health care, U.S. life expectancy from birth is one of the lowest among industrial countries.

According to an OECD report, health care in the U.S. is excellent. It does especially well in acute care but does poorly in keeping those with chronic diseases such as diabetes, asthma and COPD from entering the hospital. The U.S. is one of the most obese countries in the world but does have one of the lowest tobacco usage rates.

The ACA (Obamacare) is imploding, as designed. To get a favorable OMB ruling, revenues were front-loaded and costs were delayed. Current premiums and deductibles are exploding, and insurance carriers are leaving the system—the death spiral has begun. The new House version (AHCA) and the Senate's discussion version (BCRA) make the system a little more market responsive, but improvements are marginal. Details can be found in a Kaiser foundation article.

Current and proposed health care systems fall far short of the capitalist ideal which made the U.S. great. Doctor and hospital costs are not transparent. Employer provided health insurance and the lack of price transparency remove consumers from searching for the best mix of quality and service. The prohibition against insurance carriers going across state lines limits competition. Drug prices are exorbitant, and current law prohibits the government from negotiating price. There is much room for improvement.

Regardless of the type of health care system, individuals need regular checkups. A person may be feeling great, but that does not mean they are healthy—they could have an acute disease that is not yet symptomatic. Similarly, a person may be feeling poorly, but it is not necessarily an indication of serious health issues. Checkups have the potential to give a better indication of a person's short-term and long-term health prospects.

Spiritual health is far more important than physical health. The quality and productiveness of this life and our final destination and eternal rewards depend on our spiritual health. Jesus has paid the price. His Word and Spirit empower us. But we have a responsibility to follow Him. Perhaps a spiritual checkup is in order. The following checklist should help.

1. Are we reading and/or studying the Word daily? Good physical health requires good and balanced nutrition. Good spiritual health requires a daily balanced diet of the Word. The Word is a source of infallible guidance, power and revelation.

2. Are we careful about what we watch and listen to? Good physical health requires that we avoid things which are bad for our bodies such as tobacco and drugs. Good spiritual health requires us to avoid watching and listening to anything which tends to move us toward the carnal and away from the spiritual.

3. Are we praying every day and within the day? Good physical health requires that we listen to our bodies. Good spiritual health requires a growing relationship with our Lord and Savior. Relationships do not grow without two-way communication. The Creator of the universe wants a relationship with us, and that does not happen without prayer.

4. Are we fellowshipping with other believers? Good physical health requires social interaction. Good spiritual health requires interaction with other believers: "Two together can withstand him. A threefold cord is not quickly broken" (Eccl. 4:12b).

5. Are we exercising our spiritual gifts? Good physical health requires exercise. Good spiritual health requires that we use our spiritual gifts for the benefit of the body. Our spiritual gifts are given for the benefit of the church and others. We gain a better appreciation of the love and power of the Lord as we engage our spiritual gifts.

6. Are we operating in faith? Good physical health requires an optimistic outlook, even if circumstances suggest otherwise. Good spiritual health requires an attitude of faith. We choose to believe the Lord over everything else. Without faith, we cannot please the Lord.

7. Have we let go of the past? Good physical health requires doctors and hospitals to correct and/or alleviate impacts of past accidents and diseases when possible. Good spiritual health requires us to let go of the past. The old way of life has passed away. Old grievances, injustices, weaknesses and sins are forgotten.

8. Are we obeying the Lord? Good physical health requires us to obey the doctor's instructions. Good spiritual health requires us to obey the Lord. Whether His instructions are to love more, give more, be holy or repent, we are obligated to obey. Without obedience, our knowledge of His ways will be limited.

"Examine yourselves, seeing whether you are in the faith; test yourselves" (2 Cor. 13:5a).

Dr. James Russell is a professor of economics and undergraduate chair of the College of Business at Oral Roberts University.

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