This Toxic Supremacis Triumphalism Harmful To The Quest For Pluralism In Sri Lanka!

By Mohamed Harees –NOVEMBER 30, 2019

Lukman Harees

‘Patriotism is supporting your country all the time and your government when it deserves it’ ~Mark Twain

It is starting to sound and smell like an oxymoron. Despite President Gotabaya Rajapaksa (GR) appearing to assume an ‘All peoples’ President’ personality, the emerging political culture is negating such an assumption. Sri Lanka is showing tell-tale signs of  fast becoming an autocratic democracy as well as a racist, ‘multi-ethnic, multi-religious and multi-lingual’ nation. The toxic wave of Sinhala Buddhist triumphalism both overt and covert continuing in the Post-election phase, gives credence to the fear that Sri Lanka has already left the station to once again become a classic case of a country, widely polarized and degenerating on the ethnic and political fronts where pluralism is deliberately eschewed. 

It is blatantly clear that this mission to create an unprecedented ‘Sinhala’ mandate for GR, was well-orchestrated through a classic Modi-style modus operandi engineered through a network of grassroot Sinhala Buddhist organizations including temples as well. Even the hate rhetoric articulated by the radical monks during the election campaign was uncannily similar to that mouthed by India’s proponents of Hindutva. Moving forward, Sri Lanka cannot travel in this toxic direction and therefore GR need to act as a national leader; a transformational leader, winning the hearts of all communities, without playing to the gallery. Time is running out to build this broken nation and heal its’ wounds.

Many hate groups which were formed with GR as their patron saint then, upon the heels of the war victory over the Tigers are now deciding to dismantle. In fact, what Ven Gnanasara said in the aftermath of GR victory gave in inkling about the purpose of  their mission: to install a Sinhala Buddhist theocratic state by subduing the minorities. He said ; ‘We built an ideology that the country needs a Sinhala leader who does not bend down in front of minorities. Now that ideology has won.”. This subtle mission to re-install Buddhist nationalism on the driving seat has been on the rise, and it received a renewed boost, after the Easter Sunday terrorist attack. Rajapaksas, often appearing alongside Buddhist monks, exploited this vulnerable situation to their advantage, by referring  to the attacks as another affront on Sinhala Buddhists by the minorities while campaigning and casting themselves as their champions, underlying the need to restore national security. It was then GR declared their candidature as well, which was the ultimate plan of this nationalist lobby. 

GR may well want to be a transformed leader (different to his previous public image). But history has proved time and again that such intentions however laudable may be nullified by those around such leaders and the toxic wave of nationalism which brings them to power. Scheming political forces and prominent Buddhist monks saw in Post-Easter Sunday the emerging need for national security and a great opportunity to realize their dreams of promoting their ultra-nationalistic agenda. They saw in GR their candidate for this mission – a future Dutugemunu and the revival of the Sinhala Buddhist heritage in the country as expected by the vision envisaged by Anagarika Dharmapala. The  Mahavamsa mind-set which lies at the core of Sinhala-Buddhist hard-line arguments that ‘this island is “theirs” and other religious and ethnic minorities are “guests”. It is thus a nationalism which sees no distinction between the Sinhala-Buddhist identity and the Sri Lankan identity. For them, other groups can exist in the country and expect to be treated with respect as long as they acknowledge the supremacy of Buddhism and the primacy of the Sinhala language and culture. As Tisaranee Gunasekara notes, “with a single story, the unscrupulously brilliant author of Mahavamsa created a nexus between war, race and religion and consecrated the task of protecting the faith as the raison d’être of kingship.” These forces even side-line Sinhala Christians too in their quest for super-ordination. In that respect. Sinhala Christians too form another minority among the majority. How the Sinhala Buddhist adversely nationalists reacted to Sinhala Christian vote base for Sajith in Negombo was a case in point. Even the glorification of violence has been used by Buddhist nationalists as a source of encouragement for conflict with non-Buddhists.

In the Alvin Toffler’s ‘wave’ language, GR’s victory may be cited as the ‘Third wave’ of victory for the ‘Sinhala Buddhist nation’ in Post-Independence history of Sri Lanka. More melody to these divisive forces came from the appointment of a (nearly) monolithic Sinhala cabinet- Ministers, State Ministers and Deputy Ministers. The first wave was in 1956, when the majoritarian lobby in the wake of SWRD’s victory was able to make inroads into the highest political seat of power to a certain extent. Although the political elites then knew full well that the monumental act of exclusion as a result of manipulating the language issue for political purposes, was bound to subvert democratic institutions and also likely to lead to “terror, they went ahead anyway. The second wave was the defeat of the (Tamil) Tigers in the hands of the (Sinhala) armed forces. During MR regime, radical right-wing Buddhist groups gained a firmer foothold in Sri Lanka’s political scene, receiving what many view as the tacit support of the Rajapaksa regime. Following the defeat of the ‘Tamil’ enemy, Muslims became “another Other”.

There is no single explanation for why Sri Lanka succumbed to ethnocentrism and majoritarianism and failed to embrace pluralism in its’ seven decades of Post-Independence history. Inter-ethnic and intra-ethnic dynamics in multi-ethnic and multi-religious societies are complicated, and Sri Lanka is no different. But, according to a social scientist and a writer on the subject Neil DeVotta, ‘a Buddhist revival in reaction to colonialism that allowed Sinhalese Buddhist nationalists to combine their community’s socio-economic grievances with ethnic and religious identities; the absence of minority guarantees in the Constitution, based on the Soulbury Commission the British set up prior to granting the island independence; political opportunism among especially Sinhalese, but also Tamil elites who manipulated ethno-nationalism when seeking power; and the sectarian violence that congealed and hardened attitudes over time all contributed to majoritarianism’. The bitter lessons learnt during the course of a bloody thirty year war did not sadly enable a more inclusive society that emphasizes common citizenship over divisive ethno-religious identities, in the light of the embedded majoritarian mind-set. The involvement of Buddhist monks in politics following independence in 1948, in effect, too transformed Buddhism into a highly politicised religion.

As Neil DeVotta further opines, ‘the British and Sri Lankan elites might have been more cognizant of the manner in which the one-person, one-vote democratic principle could lead to majoritarianism, and they could have designed institutional checks and balances to protect against this outcome’. Adding salt to injury, the policies and practices, both UNP and SLFP leaders and governments effectuated were also anything but gradual and judicious. Indeed, they were so divisive and destabilizing that Nigel Harris ((1990), National Liberation) aptly noted, “If the Gods had wished to destroy, the madness of Sri Lanka’s rulers gave them every opportunity; for “if the Tamils had not existed, Colombo would have had to invent them. And, in an important sense, it did. It was [Sinhalese elites in] Colombo that forced the inhabitants of the north to become different, to cease to be Sri Lankan and become exclusively Tamil’. 

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My Plea To Your Excellency President Gotabaya Rajapaksa

What Sri Lanka needs now is a capital and investment flow from regional and international companies for both Small- and large-scale companies.

 

by Sri Lankan Patriotic-2019-11-30

 

I’m writing this with the hope and expectation that your excellency would turn this Island as one of Asia’s vibrant economies. 6.9m Sri Lankans voted for your excellency with a great expectation that you would become Lee Kuan Yew of Sri Lanka. 6.9m Sri Lankans have placed their faith and confidence on you to turn this Island into another Singapore in Asia with rapid development, prosperity and rule of law. 6.9m Sri Lankans strongly believe that Sri Lanka urgently needs an iron man to take this country out of corruption, fraud, mismanagement and political chaos. Now, you are blessed with mandate of more than 6.9m Sri Lankans to demonstrate your leadership skills, patriotism, and integrity. Now is the right time to act and deliver. People put their trust and hope on you to make a difference in politics. Now, the ball is in your corner. You could make this country either one more Singapore or turn it a failed state. It is entirely up to you and your teams who guide and advise you to make a difference in politics. It is entirely up you to introduce a new political culture in Sri Lanka. Otherwise, the same 6.9m Sri Lankans will send you home in five years’ time.

 

 

I’m very much impressed with your development projects: I understand that there are some strong teams behind you to develop this nation. There are some highly qualified academics, professionals and experts behind you to advise you what to do and what steps to take to develop this nation in education, agriculture, business, heath, environment protection, defence, and community harmony. After listening to some programme in ITN (Doramadalawa), I’m so impressed that you have a good program to develop this nation. I’m very much fascinated to see you a man of action rather than a man of political rhetoric. That is exactly what we need in Sri Lanka right now. We need an upgrading in many public departments. I will share my thought in some areas that we need improvement and updating. I hope that your teams of experts and advisors read this article and take some actions in these areas. I’m writing this with a good intention to see some dramatic changes in Sri Lanka in coming years.

 

Within one week, you have taken some positive steps to make a difference in Sri Lanka. You have cut the numbers of your personal security guards and you have removed your photos in public offices. You have Taken some austerity measures. You have taken some steps to clean up our cities. You have limited your cabinet into 15 members. You have limited official trips of your MPs abroad. In fact, you have taken a positive signal to cement inter-community relationship between all Sri Lankan communities. You have taken some good steps to create a Sri Lankan national identity among all communities without any racial discrimination. So far, we have seen some positive things from your good leadership. We hope that you create a political legacy in Sri Lanka with support of all communities. We hope you do not give a space for crook and corrupt politicians once again in this country. We hope that Journalists who report on fraud and corruption will not disappear from Sri Lanka soon. We hope and pray that white van culture will not come back to Sri Lanka at all. We hope that rule of law will prevail in Sri Lanka. We hope people will have freedom to express their views without any fear.

 

You have appointed your elder Brother as your PM. By doing so, You have created a history in Sri Lankan politics. I do not have any qualm about it. I do not mind it, if it is for the greater interest of this nation. I hope and pray both of you do not misuse this vested power. I hope that your elder brother does not repeat his old mistakes once again. I hope you have a hold on your MPs. I hope that you give nominations for next general election only for some qualified people among our communities. A team of highly educated and honest MPs could make a difference in Sri Lankan politics. We should select and elect some highly qualified people into Sri Lankan parliament. That will make your projects and your task easy.

 

If new government fails on its promise to deliver, the 6.9m people will turn their back on this government to send it home. In politics anything could happen in a couple of days/months or years. So, you must take this leadership challenge with the utmost commitment and dedication. Winning the hearts and minds of public in politics is not an easy task and yet, you have done that now, but keeping this public goodwill would be a daunting task unless you take some firm measures to introduce a new political culture and discipline.

 

Make sure that you make a distinction between your family and professional life. Keep all family connection out of your politics and out of public duties. Last time, your brother did not make that distinction in fact, he gave jobs to all his relatives, friends and cohort. They all damage his good name in politics. It took sometimes to regain his popularity. Some of corrupt cohort put the country into a near bankruptcy: Do not repeat the same mistake if you want to survive your political career. People have hope and confidence on you now but do not shatter that hope. I understand that have created different teams to develop this nation. I’m fortunate enough to listen to some of talks given by you and your teams. All are ambitious projects and programs. To do all these development programs we need some honest and dedicated politicians. As a Sri Lankan who love my mother land, I share my thought with your development program.

 

Education:

 

We are living in an age of knowledge-based economy. If your excellency want to see rapid development and program in Sri Lanka, we must make some radical changes in our education. Our school and university education systems have got an outdated teaching and learning system. Teaching and learning pedagogies are outdated. Radical changes are needed in our education both in school and university education. I hope that your excellency will take some drastic action to update our education. Sorry to say our teaching recruitment system is outdated too. Not all graduates could teach. Teaching is an art itself. We do not recruit teachers through a vigorous teaching training program.

 

In western countries graduates must have credits in Language and Mathematics to become teachers in any subject. They train graduates with some teacher training programs such as PGCE. I think Sri Lanka badly needs some teacher training programs to train our graduates. No point in giving teaching jobs for graduates without any training. Today, teaching is a demanding profession. Without training, how could we expect to give teaching jobs for graduates. Teachers produce our next generations. Teachers are resource persons who train our children/next generations. If teachers do not know what to teach and how to teach? They will spoil next generations of Sri Lanka. Teachers are resource persons who guide and who direct next generations of our community and yet, we do not recruit trained teachers. This is, indeed, greatly detrimental to our education.

 

So, I hope new president takes some measures to improve quality of our teaching in schools and universities. Our university education badly needs some radical changes. Each one of us know our university education standard is not to any international level like that of Singapore, Japan, South Korea and any western countries. why is this? Some academics in our universities are not qualified to teach. Sorry to say this but this is a bitter truth. Look how our university lecturers are being recruited. It is same as how we recruit teachers to our schools. Some university lecturers do not have skills and talent to teach at university. I do not blame them, but I blame our system of higher education. In western countries, university students have right to complain against any university lecturer who teaches poorly. In fact, western universities have got a monitoring system to monitor the quality of teaching in universities.

 

Students are given a questionnaire in each term to report about the quality of teaching. Some academics are sacked and fired for poor quality of teaching. University academics get a good salary now in Sri Lanka and yet, university administration does not how make them work for university and for the country. So sorry, some academics come to work one or two days per week and do not put their time and energy to prepare lectures.

 

I hope, your excellency take some measures to make a difference in university education. Otherwise, your dream to make this country as one of Asia’s developed counties will not be feasible. Education, Education and education was the slogan of British PM Tony Blair to win his election campaign in 1995. I hope your time in USA might have given you some practical experience to know about western education system. I think that Sri Lanka must have some government schemes or collaborative teacher training scheme with some western universities to train our graduates in some western countries. We need this to learn modern teaching pedagogies and methods. Countries such as Malaysia and Singapore send their teachers to get teacher training in western countries. We should send some of our graduate for PGCE courses in western countries if we really want to develop our education.

 

Economy:

What Sri Lanka needs now is a capital and investment flow from regional and international companies for both Small- and large-scale companies. What Sri Lanka badly needs now is a job creation in Sri Lanka. Due to 30 year’s war and communal violence in recent time, international companies did not come to Sri Lankan rather they went to Bangladesh and Vietnam and some other countries. Moreover, our education system is not updated to produce professionals for international market. Today there is a good demand for some professionals in western countries. IT professionals, high tech professionals, health professionals, educational professionals and some business professionals have demands in western countries. yet, our universities and colleges do not produce all these professionals. High skill migration brings a huge amount of money to India, China and other countries. Our politicians and policy makers must think about this rather than sending housemaids to Middle East countries. Singapore has Branches of many international companies, banks, research centres and universities. Unless, we attract international investors and companies, there is no way, we could see economic growth in Sri Lanka with limited natural and human resources we have. Of course, tourism is one of the most income making avenues we have in Sri Lanka. Tourism development in Sri Lanka needs some strategic planning and international marketing.

 

I think that Sri Lanka could consult and seek advisors of some experts from Malaysia, Singapore, Turkey and other countries to develop our tourism and other industries. Today, tourism is a competitive market in this modern world. Historical places, tea plantation, beautiful beach and natural resources of Sri Lanka are ideal for tourism. Our climate and natural resources are ideals for tourism industry. Yet, we have not managed to attract more than I one million tourists per year. That tells a lot about mismanagement of tourism industry in Sri Lanka. Sri Lanka is a Buddhist country and there are over one billion Buddhists in the world today. This includes China, Japan, Koreas, Burman, Vietnam and other countries and yet, we have failed to attract Buddhist tourism? Why? Sri Lanka has got some oldest historical and religious places and yet, we have not attracted these tourists.  Likewise, so many Arabs now visit Sri Lanka. we must give them a good impression about our country. If an Arab goes to Japan, Japanese hotels provide them with prayer mattes and prayer compass to find out direction of prayer. We must give them some such facilities to attract Arab tourism.

 

Diaspora communities:

 

Sri Lanka has utterly failed to make use of Sri Lankan expatriate communities abroad. Politicians make political rhetoric about these people and they invite them to come back. But they have no mechanism to make use of these Sri Lankans who live abroad. Over 1.5 Million Sri Lankans live in many western countries. Successive Sri Lankan governments have utterly failed to benefit from this sri Lankan migrant communities. Sri Lanka has failed to use their talents, skills, experience and their capital investment. Countries such as India, Bangladesh and Pakistan get a huge of amount foreign remittance from Western countries. Yet, Sri Lankan has failed to attract capital investment from its own citizens in western countries. our dual citizenship concept has not attracted expatriate Sri Lankans to come and invest in Sri Lanka. In this digital age, Sri Lankan immigration and High commissions in Europe are working in stone age style. They are working in old fashions. For a Sri Lankan expatriate it will take more one year to get a dual citizenship certificate. There is not any efficiency in immigration department back home in Sri Lanka to speed up this process. Because, many officers do not do their jobs on time for some obvious reasons. If it is the case, how could Sri Lanka expect to benefit from 1.5m expatriate Sri Lankans? The Sri Lankan immigration department needs some radical change with some new innovative ideas to speed up its process in dealing with public.

Rehabilitation

INDRAN AMIRTHANAYAGAM- 11/14/2019

The outgoing president of my former country just pardoned

Jude Jayamaha, murderer of the young Yvonne Jonsson, who had

dual Sri Lankan and Swedish nationality, bludgeoned to death

in an apartment at the luxury Royal Park flats. The victim’s skull

shattered Into sixty-four shards. The killer got twelve years at first,

was sent later to Death Row, from where he has been released

for good behaviour, according to the president, who happens also

to be a distant relative. Prisoners at Welikada have climbed

to their roof shouting, we too must be set free. The story is making

national, global news. The imperious president. What is the right

payment for murder? Who will greet the killer now at cocktail

parties, in the cinema? Yes, that is the Royal Park killer? Perhaps

he will sit for plastic surgery; change his name; go abroad,

as he has money. Maybe he will take a room in the town

where the surviving sister resides? She may also live in Colombo.

After all, she too is a dual national. Perhaps they will bump

into each other at Majestic City, or in the Crescat complex,

on the green at Galle Face? What will they say to each other?

Indran Amirthanayagam, (c) November 13, 2019

Two versions of Rajapaksa authoritarianism

Reflections on a Mahinda-state versus Gota-state, puzzle

by Kumar David-November 30, 2019, 3:11 pm

Of course I am disappointed by the presidential election outcome for two reasons. I wished for at least 700,000 votes for Anura to kickstart an alternative to the rotten two-party hegemony of the post-1975 decades; second, I wanted Gota defeated as I perceived in him as an autocrat. The first was unexpected as I was confident Anura would do much better. Regarding the second, those who read me between the lines would have realised that I did not expect Sajith to win outright and was pinning my hopes on a second-preference count. In the event even Anura’s total absence would not have mattered, the swing to Gota was huge among the Sinhalese and especially the Sinhala-Buddhists (SB).

I have mulled over the statistics and confidently assert that 72% of SB voters opted for Gota. Well over half non-Buddhist Sinhalese also supported him thanks to the untiring efforts of our blessed Cardinal. The former votes alone would have pushed Gota just over the 50%+ mark; the latter cemented a comfortable first-count majority. Tamils, and more so Muslims, voting for Gota were negligible in number. Statistically and politically this is a historic election and has changed Sri Lanka in ways irreversible for a long time to come. I will not discuss the setback for a democratic-left option due to the NPP/JVP’s poor showing; that will be the topic of a separate essay, later.

It is incorrect to refer to this election as a return to 1956. No! First, SWRD’s SB vote was in no way comparable. No, 70+% of the SB population did not align with the SLFP (the landslide was in part thanks to a no-contest pact with the left). The key was that 1956 was a first-past-the-post (FPTP) election. In an FPTP contest, technically, a party can win every single seat in parliament if it secures 50%+1 vote in every electorate. I have to work from memory as I cannot afford the time to dig out and analyse statistics, but I am confident the SLFP in 1956 did not garner even 60% of the Sinhalese vote, probably in the high 50s. The second difference that recent writers all too readily forget is that in political character the ‘1956 movement’ and the ‘2019 rush to Gota’ are poles apart. The former was populist, vernacular-nationalist (Sinhala Only), progressive in class terms even posing as leftist, and distinctly democratic in its social overtones. Gota is none of this. Even his ‘Sinhalaism’ is couched in national-security statist terms. In all respects what SWRD is to Gotabhaya is what centrist-populism is to potential authoritarianism.

I know some readers will say: "Gota is a new President; give him a chance". That’s fair and I agree; but there’s nothing wrong in getting one’s guard up, just in case. Defence can be scrapped if not needed; to be caught flat-footed is calamitous. I am not prepared to relax to the extent that I concede that the authoritarian danger I wrote about these months has evaporated. On the contrary, because of the highly ethnically polarised election results, the danger has increased. Two versions of authoritarianism have emerged globally in the post WW2 period; a nativist-nationalist-statist version and, alternatively, a populist paradigm. And if you want to put a face on each you can colour them the Gotabaya version or the Mahinda paradigm, respectively.

And that brings me to my point. Is Gota really interested in holding state power for one full term, or even two, or is he only "the one who comes before preparing the way and making straight the path for him who is to follow"? Does Gota really want to be president and implement his programme or will he swiftly carry out constitutional changes needed for Mahinda’s return for a third term, and eventually life presidency? No one knows, least of off all the two protagonists. The answer is as yet unknowable. It depends not only on their own ambitions but also on the schemes of the family cabal and the forces that stand behind each of them. Mahinda’s base is an adoring populist mass, Gota’s the Shangri-La class of business and military types, professionals and technocrats, oddly garnished with cohorts of militant yellow-robed racist hate-mongers. In a showdown, MR’s populist mass will win hands down, at least that’s the current balance; Shangri-La cannot match Mahinda’s mass. After all there is no denying Gota won the presidency thanks to Mahinda.

But not all the cards are stacked in Mahinda’s favour. The main obstacle standing in his way is the Constitution and 19A. It’s not breaking news that most of our MPs are available for sale on cash-down terms (money or Cabinet post), or on hire-purchase (nomination for a seat in the next election). Like my fellow citizens I am no admirer of Sri Lanka’s Members of Parliament. If it is decided to bring Mahinda back to the presidency pronto, then a constitutional amendment is possible even before the election using the cash-down method. Or it may be less messy to wait for the 2020 elections, which Mahinda will win by a landslide, and screw the constitution at a more leisurely pace. If FPTP or part-FPTP is restored, the landslide will be a repeat of 1956, 1970 or 1977.

That equation will have to include an agreement between MR, GR, the family cabal and Gota’s business-military types about when Gota should quit and hold presidential elections facilitating MR’s expeditious resumption of the presidency. Or perhaps the equation will allow Gota to complete his term; but isn’t that risky? Won’t he and his loyalist hangers-on then want the constitutionally allowed second term? If term-limits are rescinded why Mahinda and not Gota as life president, they will boldly ask? There are knowns, known-unknown and unknown-unknowns. No one knows nor can know how all this will spin. So, let’s leave speculation to one side and turn to a known-knowns.

Whether it’s the MR manifestation or a spectral Gota haunting, Sri Lanka is in for a long grip of authoritarianism; but the two versiosn will be different. The Mahinda version will be populist as were his 2005-2015 presidencies; there will be a velvet glove of welfare and concessions to popular pressure. Argentina’s Peron or Mahathir’s long former spell as PM spring to mind except that neither was corrupt. A Gota autocracy will reflect the style of the man and the expectations of those who want him "to get on with the job". It will be less class conciliatory, make short shrift of liberal niceties and get on with the job in the name of efficiency. He has expressed a commitment to modernisation and global opening-up, technology especially IT, renewable energy and environmental protection and comes over as a problem-solver and a doer who has proved himself, controversially as Defence Secretary and creditably as urban reorganiser.

He is painted, justifiably to go by experience, as a threat to democratic rights and freedoms. An old friend and one-time university leftist, now a devoted Gota admirer, joked that he hoped they retained one last white van for me! Though both are avatars of authoritarianism, the two will impact on personal lives and social spaces differently. The Gota version, it is feared, will be harsh, the Mahinda option avuncular. What the two have in common is that, given the electoral antecedent, both when under pressure will stabilise themselves by an appeal to nativist Sinhala-Buddhist ideology. That ideology will not go away because it was the people themselves who willed it. I am aware that this is a pessimistic thesis, but my task is to tell you the truth not lull you with soporifics.

Does this mean that we must throw up our hands and do nothing? Absolutely NO! Even on the darkest nights there are things to do. I will conclude by stating the most urgent; recall my comment about "getting ready, just in case". The imperative in this phrase is the "getting ready", not the "just in case". A defensive non-regime alliance, not only political but also including the political parties (UNP, JVP, minority parties) and civil society, journalists and artists, must be formed. The programme must be minimal: Resist the creep of dictatorship by legislative statutes, state repression and in ‘vans’ of any colour. The JVP has to take the lead since the UNP is comatose after its knockout.

Come on everybody let’s get started. Defeatism following a defeat is suicide; know your enemy, know the terrain and know yourself.

Sun Tse say:

If you know your enemy and know yourself, you can win a hundred battles without a loss.

If you only know yourself, but not your enemy, you may win or you may lose.

If you know neither yourself nor your enemy, you will always lose.

The Art of War (2nd Century BC)

Sri Lanka: In Need Of Wise Laws 

By Mohamed Faizal –NOVEMBER 29, 2019

Mohamed Faizal

It is the greatest of men who take to politics, and they do so due to the fear of being ruled, in their abstention from politics, by those who lack greatness and are below them. That was Plato talking.

Greatness of a ruler is not found in him simply being a ruler, but in being able to produce wise laws – laws that are good for everyone, both at present and in the future. If there was no wisdom in his laws, then there is no true greatness in his rule – whatever is perceived as greatness is only an illusion, which would soon be exposed; his foolish laws would cause a lot of suffering to his people, who would later curse him for it; and history would judge him unfavourably. Such a ruler who may temporarily be able to delude his people, before being eventually exposed, is an imposter, says Rousseau.

Rousseau also says that for a ruler to attain true greatness he must be not only wise, but also inspirational: since people don’t generally understand the wisdom in the laws of a wise ruler, a ruler deserving of true greatness must be able to make his people believe in his wise laws. He cites the example of Prophet Muhammad as one such a great ruler. Only a few might have truly understood the wisdom in his laws, but he inspired everyone to believe in them.

When people continue to believe in the wisdom of a ruler, he becomes immortalised: his death doesn’t harm his kingdom; despite his physical death, people continue to preserve and propagate his kingdom; if there is a decline in his kingdom, they try to revive it; and if there is a collapse, they try to re-establish it.

Today’s electoral system, which is being touted as the best system, belies Plato. In it, it is the lowest who have the greatest chance of winning; the greatest have none. Elections becoming almost unanimous with lies, deceit, fraud, intimidation and other forms of violence, the lowest take to it like a fish to water, while the greatest run away from it as if it were a leper. Surely, the rulers born of such a system are not the greatest. That might appear to be quite a harsh remark to make, but that is the truth, which any objective observer can see for himself. Our rulers, being not the greatest, aren’t taking up political positions for fear of being ruled by those who lack greatness and are below them, but for a different motive – perhaps it is wealth.

The ocean of lies, deceit, fraud, intimidation and other forms of violence, which a politician waddles through before being elected to an office, after all, doesn’t give him more than a few years in office. The gross legal income a politician would receive for his complete tenure is likely to be only a fraction of what he would have spent on his election campaign. What can we now expect from him? It would be foolish to expect him to spend his time on improving the quality of life for the masses he loathes – he certainly loathes the masses who fell for his lies, deceit, and fraud, and acquiesced to his intimidation and other forms of violence.

Unlike the general masses, politicians aren’t foolish: they know where their self-interest lie, and they know how to secure it. They spend their time in office recovering the money they spent on election campaigns and charging the public for whatever labour they put in to win the election. The relationship between these rulers and the masses is no different to the relationship that exists between the conqueror and the conquered; for the conquerors always get the conquered to foot the bill for the conquest. This is evident for some of us to see, but we have taught ourselves to quickly push this painful truth out of our consciousness.

A truly great leader unites all his people. What unites different people are common thoughts, which a ruler nurtures in his people via his laws. Uniting people of different languages, religions and ethnicities – such as we have in Sri Lanka – is a challenge which only a great leader can successfully accomplish. He does it with his wise laws, which treat everyone equally and benefit everyone equally. He inspires his people with belief in them.

An imposter on the other hands, unable to foster cooperation, only creates inter communal divisions. He incites racism, opening up chasms between communities and destroying any good relationship that may exist between the communities, but at the same time unifying individual communities internally. In the electoral voting system we have today, uniting internally the community that is numerically more than half, is enough to easily win elections. That is precisely what the imposters do: create intercommunal disunity and intra-communal unity.

These imposters make pompous claims to be nationalists and pretend to be religious, the goal of which is to deceive their people. Their claim to be nationalists is false, for they pit one community against the other and work against the national interest. Their claim to be pious is false too, for no pious person would ever seek political greatness by standing on the dead bodies and destroyed properties of other communities, as a result of the racism he aroused.

If the anti-nationalism of the ruler is hidden in his racism, his impiety is glossed over by the prelacy. A marriage of convenience exists in this country between corrupt politicians and the prelacy. Their marriage is so convenient that they keep forgiving each other: the sinful politician and the criminal priest keep forgiving each other so that they can continue sinning and committing crimes. The politician forgives the criminal priest and gets him out of the prison so that he can re-offend, while the priest forgives the sinful politician and erases all his sins, making it impossible for god to hold him to account after his death.

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Politicians, economists laud tax cuts

Jayasiri Munasinghe and Amali Mallawaarachchi-Saturday, November 30, 2019

The sweeping tax cuts announced this week by the new Government led by President Gotabaya Rajapaksa were lauded by many businessmen and politicians stating that those were likely to give impetus to stronger corporate earnings. They pointed out those proposals when implemented would help boost the ailing economy. Many of them expressed their confidence that the new tax concessions announced at the first Cabinet meeting under the newly-elected President Gotabaya Rajapaksa would benefit the public at large while revitalising the local economy by reversing the previous regime’s unsuitable economic policies which imposed heavy tax burden on the country.

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Immediate and substantial boost in consumer spending - CAL

Meanwhile, Capital Alliance (CAL) Research, an independent research unit that provides comprehensive research and analysis of Sri Lanka’s equities and economy, said in a note that the new tax concessions are likely to trigger an immediate and substantial boost in consumer spending.

“The tax cuts will certainly, however, be seen as significantly market positive. Nonetheless, given the lack of information at this point – we advise our clients to play the ‘Sure Winners’ viz a market-wide momentum-trade,” it stated.

The CAL Research said it believes that the earnings of banks and financial services would see an immediate boost upon the removal of Debt Repayment Levy and NBT. Withholding Tax removal may also see borrowing costs reducing over the medium term, it added.

It further commented that the earnings on the consumer sector are likely to boost from PAYE tax removal.

“The removal of PAYE tax is likely to increase the disposable incomes of consumers thereby boosting consumer volumes substantially,” it added.

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How would the Govt. cope with revenue loss? – Dr. Harsha de Silva

Former Economic Reforms and Public Distribution Non-Cabinet Minister Dr. Harsha de Silva, commenting on the new Government’s abundant tax concessions, questioned how the Government hopes to cope with the revenue loss expected from the new proposals.

“The new Government must be hoping for a huge increase in economic activity and resulting tax collections to offset the Rs. 630,000 million expected revenue loss. This is 30 percent of the expected revenue based on 2019 figures. If not, it has to be a hoax till general election,” Dr. de Silva said.

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Tax burden was a barrier for new industries - CEETA Chairman

Chairman Colombo Electrical Equipment Traders Association (CEETA) Chairman P.G.S. Dhammika Samarawickrama said their membership was reeling under a heavy tax burden preventing them from starting any new undertaking. The new tax relief granted by President Gotabaya Rajapaksa would enable them to import raw materials for new production industries and increase sales of imported items as well.

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More tax concessions soon - Minister S.M. Chandrasena
Environment, Wildlife, Land and Land Development Minister S.M. Chandrasena commenting on the tax cuts introduced by the new Government predicted further tax cuts in the near future.

Responding to the media, Cabinet Minister Chandrasena said the proposed tax cuts will be presented to Parliament for approval. “When Parliament sits again, hopefully we would be able to get these proposed tax cuts passed,” he added.

“The previous Government did not know how to develop this country. All they knew was how to impose a multitude of taxes on the people and oppress them. We are glad that we were able to introduce all these tax cuts in the first Cabinet meeting.” Minister Chandrasena said.
He also said all communities in the country should get together to develop the country. He also said they are committed to make President Gotabaya Rajapaksa’s election manifesto a reality.

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Tax cuts aimed at General Election - MP Vijitha Herath

Speaking on the recent tax cuts introduced by the new Government, Janatha Vimukthi Peramuna (JVP) MP Vijitha Herath expressed their distrust on the Government’s move.

MP Herath responding to the Daily News said the new Government, like all previous Governments, gives concessions to people aiming at the next General Election. These tax cuts and concessions are temporary, MP Herath observed.

MP Herath pointed out that the previous Yahapalana Government also did the same when it was elected in 2015. “If you can remember, that Government also came up with all sorts of concessions and tax cuts. They even came up with fancy formulae to bring certain prices down. It is obvious that these tax cuts are also temporary. Every new Government comes up with tricks like that. They will definitely increase the taxes once the general election is over,” he pointed out.

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Development through broadening of the production and services economy commendable -New Innovations Circle head

New Innovations Circle Chairman Dr. Amila Kankanamge said no country had been able to march forward economically by depending on taxes to raise its income.

It was imperative for a Government to increase people’s income through the broadening of the production and services economy.

He said the tax burden which was a disincentive for investments had been eliminated. It was a commendable step taken by President Gotabaya Rajapaksa.

This was the initial step. The second and third steps should be to develop the export market by promoting agriculture and industrial service sectors and thereafter bring in direct foreign investments.
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Will revitalise economy and uplift SMEs - Azath Salley


Former Western Province Governor and National Unity Alliance Leader Azath Salley said he was happy with the new Government’s decision to make tax concessions during their first Cabinet meeting under the guidance of President Gotabaya Rajapaksa. “This will revitalise the local economy and assist Small and Medium Scale Enterprises (SMEs) in their development,” Salley said observing that the initial signs of President Rajapaksa’s rule were “very encouraging” and that people would support his moves.

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Strengthening of economic standards will be expedited -Fmr CB Director



Former Central Bank Director and veteran Economic Analyst Vincent Mervyn Fernando said the proposed tax relief would expedite measures taken to strengthen the economic standards of people.
These relief measures would not only empower small and medium scale entrepreneurs and microfinance activists, but also the large-scale business community. Generally, they would create a new economic re-awakening in the country.
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Share transactions in service sector will increase - Financial analyst Ravi Abeysuriya

Financial analyst Ravi Abeysuriya said tax relief granted to stock market transactions had helped to revive the stock market.

This will increase share transactions of listed companies which served the service sector.

Local investors had received avenues to meet their financial requirements from the financial market instead of depending on the banking system.
This was a very salutary measure.
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Tax concessions, highly commendable  - Colombo Business Association General Secretary


General Secretary, Colombo Business Association Chaminda Vidanagamage said they highly appreciated the steps taken by the Government to grant overall tax relief. The decrease of the VAT from 17 to 8 percent was a highly commendable gesture on the part of the Government.
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Signals a rival in economy - SLFP Colombo North Chief Organiser

Colombo North Sri Lanka Freedom Party (SLFP) Chief Organiser Devamunige Nishantha de Silva said despite various constraints, President Gotabaya Rajapaksa had reduced VAT and other taxes in keeping with his election pledges. He said VAT had been decreased to eight percent and all this signalled a revival in the economy under the President’s stewardship.

Guarantee rights of the disabled - DOJF

BY RAJITHA JAGODA ARACHCHI-1 December, 2019

The United Nations Charter for the Rights of Persons with Disabilities was signed in 2007, to facilitate persons with disabilities. Although Sri Lanka also signed it, committing to implement universal provisions, there is no progress to date. Pix: Lake House Media Library
Many people look at persons with disabilities, with compassion. All they really want is just their rights. However, the Disabled People’s Organisations Joint Front (DOJF) is in a battle with successive governments (for nearly two decades), to create a society where the rights of persons with disabilities are guaranteed.

While the entire world is celebrating and organising awareness activities targeting International Day of Persons with Disabilities, the Chairperson of DOJF, Rasanjali Pathirage in an interview with the Sunday Observer talked about much needed changes for the community she represents.

A common voice

Over the past 70 years, Sri Lanka has experienced many disasters, including war, riots and bomb blasts. These resulted in an increase of disabled persons apart from the huge number of people born with a permanent disability. According to the 2011 census, the country has about 1.8 million people living with disabilities (which is eight percent of the population). DOJF was formed in 2001 as an umbrella organisation for 30 other organisations that represent persons with disabilities. Which means that DOJF represents each and every person in Sri Lanka with any kind of disability.
“Before we started our organisation, others with disabilities had stood for their own individual rights. DOJF was created to raise a common voice,” she said.
By Parliament Act No. 28 of 1996, Sri Lanka ensured the protection of the Rights of Persons with Disabilities which was never fully put into practice. For example, Section 5 of the Act emphasizes that disabled people should not have a problem when entering a building. A special gazette in 2006 outlined how all government buildings should be made accessible to disabled people. In the absence of its implementation, in 2019 Dr. Ajith C. Perera a pioneering activist in rights of the people with disabilities, obtained a verdict from the Supreme Court for the betterment of thousands of persons with disabilities.

“The first case was filed against the Ministry of Justice. It has not yet complied with the court order,” Pathirage said.

Rights limited to documents

The United Nations Charter for the Rights of Persons with Disabilities was signed in 2007, to facilitate persons with disabilities comprising about 15 percent of the world’s population. Although Sri Lanka has also signed it, committing to implement universal provisions, there is no progress to date, Pathirage believes.

“For 12 years now, we have failed to pass the domestic legislation on the UN Charter. Every government made plans. It’s all in the documents. They were never implemented on the ground.”
Sri Lanka has always been known for planning and making reports, rather than implementing. Plans made to ensure the rights of persons with disabilities fall into that category. In addition to the 1996 Act, there is a gazette notification that came into effect in 2006, followed by a Supreme Court ruling in 2019.

Further, Sri Lanka has a National Action Plan on Disability prepared by the Ministry of Social Services in 2014.

Despite this, the rights of persons with disabilities have been presented under the National Plan for Human Rights Promotion, which was introduced in 2017 on the intervention of the then President.

However, India is far ahead of Sri Lanka in this regard. “I was born as a person with a disability. When on the stairs of a train, I can never lift one leg and then the other. So I could never go on a train. But India has passed its local legislation and has implemented same including the accessibility to trains,” Pathirage said.

In 2017, members of DOJF, headed to the United Nations Human Rights Council (UNHRC) in Geneva and eventually gained a new opportunity to fight for their rights.Thus, during the budget debate of 2018, there was a discussion about people with disabilities and Pathirage and others met the COPE Committee and the Public Accounts Committee.

The two committees investigated government expenditure on persons with disabilities.

“When we went to Geneva, we had conversations with many parties. Officials and Ministers of the Ministry of External Affairs of Sri Lanka spoke with us in a very friendly manner. But after coming back to Sri Lanka, nothing of what was promised was implemented,” Pathirage said.

Need for a joint mechanism

Following the announcement of the 2019 presidential election, various organisations, including DOJF, demanded all main candidates to include a chapter on the protection of the rights of persons with disabilities, in their policy statements.

President Gotabaya Rajapaksa presented a detailed program, so did the two other main candidates, MP Sajith Premadasa and MP Anura Kumara Dissanayake. President Gotabaya promised the full implementation of the United Nations Charter in Sri Lanka and to develop a mobile app for the communication needs of the disabled. People with disabilities now want to see the implementation of these election promises.

“It was Gotabaya Rajapaksa who first started using ‘tactile’ on the roads in view of the visually handicapped. We have great faith in him.We asked the President to create a mechanism to connect all ministries and government institutions to facilitate persons with disabilities. The President agreed to create a program with our representation,” Pathirage said.

Communication channels

During the Easter blasts in April, a curfew was imposed for several days across the country. While the public received information about the curfew through various media platforms, the hearing impaired did not get the message.

Communication for people with hearing impairment is entirely based on sign language. They have difficulty reading or writing and understanding what someone else says. Sri Lanka Rupavahini Corporation is the only media institution in Sri Lanka that currently uses sign language. Their major news broadcasts features news in sign language.

“There are about 400,000 hearing impaired people in Sri Lanka. But we do not have even 10 sign-language teachers. Also there is no Act or Law on the use of sign language, yet. So hiring sign language training personnel is also a challenge,” Pathirage said.

The Sustainable Development Goals of the United Nations represent an inclusive journey in development. Hence, if a country is to be considered as developed in this century, it is imperative that development benefits must flow to everybody. Whether Sri Lanka is ready for such a broad program, is still a big issue.

According to Pathirage, even the ministries which directly deal with people with disabilities simply ignore their empowerment.

“There is very little involvement of people with disabilities in Health Ministry programs. Particularly, in education programs on sexuality. People with disabilities do need to know of such things.”
Pathirage also pointed out that despite the high incidence of abuse of women with disabilities, none of the political parties have paid any attention to it. “There are over 900,000 disabled women.
Even if they are abused there is no legal solution they could take. People with hearing impairment/ intellectual disabilities are abused a lot. They don’t even know about the injustice they face.”

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We used to know how to manage discomfort. Our quest to banish it brought on the opioid crisis.

By James D. Hudson-November 27, 2019

I was a third-year medical student in 1976. My first clinical rotation was in general surgery. The chief resident explained that a patient’s abdominal pain was the most useful tool we had in distinguishing the life-threatening condition of acute appendicitis from a more benign ailment such as stomach flu or constipation. He warned us not to treat that pain before the attending surgeon had a chance to place his hands on the patient’s abdomen. We were also encouraged to listen carefully to the patient’s experience of pain, the timing, the duration and any factors that made it better or worse.

Forty years later, our concept of pain couldn’t be more different. Instead of learning from pain, we now regard it as an illness in and of itself. Insurance companies, health-care providers and drugmakers have all worked to increase the public’s fear of pain, leading us to see it as something to be treated, eliminated, banished — never lived with or accommodated or managed — lest it destroy us. They turned our natural fear into big business; our fee-for-service system has multiplied treatments based primarily on the financial rewards for pharmaceutical companies, doctors and hospitals. That attitude shift is perhaps the most overlooked explanation for an opioid crisis that kills tens of thousands of Americans every year.

It’s good to have a healthy fear of pain. It protects us from injury and reminds us to allow time for healing. Acute pain can be made more tolerable by a short course of opioid medication (the Centers for Disease Control and Prevention recommends only three to seven days, even after major surgery or injury). And there is a good case for using opioids over longer periods to treat end-stage cancer and other terminal ailments that can bring unbearable suffering. Palliative care in those situations is almost always necessary and compassionate.

But otherwise, the fear of pain, and the belief that a pain-free existence is optimal or even possible, has been a catastrophe for patients. Before the opioid revolution, doctors understood that pain was important to keeping us safe, to be lived with and managed. Even if this meant we bore frequent episodes of discomfort, that was better than the nationwide crisis America faces today. Life isn’t “pain free.” If we want to end the epidemic of addiction, we need to relearn that lesson.

Early in my career, I worked at a chronic-pain rehabilitation program in Grand Rapids, Mich. Here I was exposed to patients with incurable pain, most commonly in their backs. Many had undergone multiple operations; others suffered with neck and extremity pain; some were victims of auto accidents or work-related injuries. Then there were those with less-understood maladies such as phantom limb pain, fibromyalgia or complex regional pain syndrome. The treatment focused on helping people get their lives back despite the pain.

In those early years, some patients came in with pills, but they tended to be relatively mild pain relievers like codeine and ibuprofen, and in rare cases a drug called Percocet (one of the first formulations of oxycodone, approved by the Food and Drug Administration in 1976). Then things began to change.

In the 1990s, Jack Kevorkian, a Detroit pathologist who had previously advocated harvesting organs from death row inmates, began using his lethal-injection machine to assist “clients” in ending their lives. His medical license was revoked, but before he was finally convicted of second-degree murder in 1999, he had assisted more than 100 people in ending their lives. He argued that this was compassionate assistance for patients with intolerable suffering, igniting a national debate about the wisdom of “death with dignity."

He challenged our profession, saying doctors did not care enough for people in agony. The implication of his argument was profound, equating life with pleasure and health care with an escape from pain and suffering. And the publicity Kevorkian received — news coverage, books, a “60 Minutes” profile — had a dramatic impact on the practice of pain medicine. In 1995, the president of the American Pain Society started a campaign to begin treating pain as a vital sign and an illness in its own right, instead of a symptom of an injury or an underlying condition. State legislatures were lobbied to ease restrictions on opioid analgesics, and enforcement was relaxed. Opioid manufacturers started aggressively marketing their products to physicians and, according to a study in the journal JAMA Network Open, this marketing correlated with overdose deaths. The CDC has thoroughly documented the rapid rise in opioid prescriptions and deaths since 1999.

Many doctors listened to the marketing campaign. In our hubris, we began to think we had the capacity to banish chronic pain. Pharmaceutical companies were developing ever stronger and longer-lasting opioids, and surgeons were replacing more and more worn-out joints. New techniques meant that pain anesthesiologists could block nerves, sever the signals to the brain, and insert catheters or electrodes into spinal columns and brains. Pain was to become a thing of the past, conquered by modern medicine.

As part of the push to defeat pain, “physician experts” compensated by drugmakers hawked these medications at conferences, telling doctors that the new and more potent analgesics were not addictive when prescribed for pain. They told us that there was no upper limit on dosing, that patients would develop tolerance to the medication and that some would need extremely high doses to control their pain. But not to worry; this was normal: A new, unsubstantiated ailment called “pseudo-addiction” was offered as an explanation for the patients who ran out of pills early and borrowed more from friends and family or got them on the street; this wasn’t because they were addicted but because their doctors were under-prescribing. In at least a few cases, physicians lost court cases accusing them of undertreating pain. (No empirical evidence has ever shown that pseudo-addiction is real.)

This evolving outlook on pain created a flurry of new business opportunities. Physicians and health systems benefited from an explosion of diagnostic testing with CT and MRI scans, for which they could bill insurers, and which led to a rapid rise in invasive treatments, injections and surgical procedures without adequate scientific proof of their long-term benefits. Incidence of spinal fusions, for instance, varies twentyfold depending on the area of the country you live in. Unethical medical practitioners were opening “pill mills,” often taking only cash for almost unlimited amounts of addictive medications with no real attempt to make a diagnosis or assess the need for such prescriptions.

[I was a drug rep. I know how pharma companies pushed opioids.]

Fear of pain can also be aggravated by pain specialists or surgeons. Patients have told me that some practitioners planted the seed of fear as soon as their treatment ended: Warning them that they would eventually need another surgery or shot. That they should never lift more than five pounds unless they wanted the pain to return. Or, if patients declined treatment, that they would end up in a wheelchair. Patients are not in a position to regard such recommendations skeptically, and second opinions are expensive, time-consuming and unlikely to countermand recommendations made by a surgeon who has operated on the patient.

Insurance companies also bear significant blame. They reimburse interventional pain treatment so handsomely that these practitioners have become some of the highest-paid specialists in the country. The Medical Group Management Association reported that anesthesiologists who specialize in pain management earn almost $530,000 on average annually, making this a lucrative specialty. In comparison, primary-care providers make less than half this (while the average physician makes $300,000), and most end up working for large health-care systems that pressure them to see more patients, a pattern correlated with an increase in prescriptions and a decrease in time educating patients about lifestyle changes and self-management.

The American public is not benefiting. Life expectancy, which had been rising for the past century in the United States, began falling in recent years because of increases in suicides and opioid-overdose deaths (400,000 fatal overdoses between 1999 and 2017). According to the National Institutes of Health, 21 to 29 percent of patients who are prescribed opioids for chronic pain “misuse” the drugs, and there is no evidence that we have any less pain. The Midwest, where I practice medicine, saw opioid overdoses increase 70 percent from July 2016 through September 2017. Meanwhile, our country spends more on the treatment of chronic pain then on cancer, heart disease or diabetes.

To this day, we have no objective way to measure a person’s pain or suffering. It is a subjective experience, and fear of it can lead patients to feel it more acutely. Research has shown that disability is driven more by fear of pain than by the degree of pain itself. Making pain a vital sign and judging the quality of medical care by how often we ask someone to rate their pain, and then treating it aggressively, have paradoxically increased both our fear and our experience of pain.

Patients with chronic pain syndrome often find that things that shouldn’t hurt do, and things that should hurt a little hurt a lot. Their pain doesn’t remain in just one area. It moves around and spreads. They suffer headaches, irritable bowel syndrome, interstitial cystitis, fibromyalgia, insomnia, and sensitivity to light, sound and smells. Their arthritis is more painful. The simplest daily activities hurt, and they become afraid to move. They often take a long list of prescription medications and supplements, and undergo multiple injections and surgeries, all in a futile attempt to feel better. Their pain is real, and the vast majority of them are not addicts. They take their medications as prescribed, but the drugs just aren’t working anymore.

None of this is predestined, and if we want to reverse the opioid crisis, a new approach to pain is a good place to start. American medical schools do a poor job of teaching the latest in pain science. Many are still teaching the 1965 “gate control theory,” which treats pain as a localized physiological phenomenon, but that concept has been supplanted by the superior “neuromatrix model,” which regards pain as a holistic experience (shaped not just by biology but also by psychology, stress, sleep and other factors) and goes much further in explaining what we see in our chronic-pain patients. Most of what is taught to medical students and residents is how to prescribe medications for pain — and almost nothing about the complexity of the body’s pain system or the ways that non-pharmacological treatments can help control it.

Patients, understandably, don’t come to the doctor wanting to learn how to accept pain. They want to get rid of it. Whenever reasonably possible, that is what doctors should do. But it comes at a cost: Our present system overpromises and underdelivers on relief, fostering dependence in the process.

[My friend and I both took heroin. He overdosed. Why was I charged for his death?]

One way of reorienting patient thinking along these lines comes from the multidisciplinary pain clinics pioneered by the late John Bonica, a pain specialist at the University of Washington. Bonica proposed that we look at the whole person. Doctors who follow his lead examine a patient’s physical and mental health, their medications, how they think, move and behave. They look at a patient’s passions and how their current life stacks up to the life they really want to live. Education is a cornerstone: They teach patients how their nervous system can either calm their pain or amplify it, then give them the skills to direct that system.

New approaches hope to teach self-management by educating patients about their bodies and nervous systems, reducing fear of pain, and treating depression and hopelessness — partly by getting them back to exercise and normal activities. Helping patients resume their lives rather than focusing narrowly on eliminating pain changes their outlook. Instead of taking pills and awaiting their next epidural, they calculate the costs and benefits of getting up and engaging in life again. They invariably fear that the pain will be too great and their ability to tolerate it too limited, and this is where caring professionals can help lead them through a step-by-step management program. Patients learn how the thoughts they have, the words they use and the beliefs that underlie them can either increase or decrease their nervous system’s danger signals.

In many ways, learning to live with chronic pain is like learning to live next to the El in Chicago. This aboveground transit system is old and loud. It roars past homes and businesses. Nearby residents feel the vibrations; it can be so noisy that they pause their conversations while the train goes by. Yet those who think a lower rent is worth the annoyance report that the sound soon ceases to be disruptive. You get used to it. Getting angry every time a train passes is a sure way to obsess over it. Our body’s pain system works the same way. The more we learn to calm it down, the less it bothers us; the more we try to be pain free, the more it takes over our lives.

Fixing our health-care system isn’t as easy. Financial incentives are set up to increase health-care delivery, not the overall health of the population, and Medicare-for-all wouldn’t address this problem. But one fix is for insurers to scrub the rules that make it cheaper for patients to continue failed pain treatments, surgeries, injections and medications. Instead, they should push for conservative care, such as physical therapy, pain neuroscience education and multidisciplinary pain rehabilitation programs, which are low-risk, high-reward enterprises that focus on improving a patient’s function. These interventions require an intensive period of treatment, but they’ve been shown to be cost-effective, giving patients a shot at becoming the people they used to be.