The Economist - USA (2019-11-23)

14 Leaders The EconomistNovember 23rd 2019

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s srilanka’slongcivilwarwasdrawingtoa closein2009,

thearmysurrounded100,000civiliansona tinysliverof

beach,barelythreesquarekilometresinsize.Mixedinamong

themwerea smallnumberofseparatistguerrillas,theremnants

ofa once-formidableforcethathadbeenbattlingforanindepen-

dentstateforthecountry’sTamilminorityfor 26 years.Thein-

surgentshadnocompunctionaboutusinginnocentvillagersas

humanshields.Thearmyclaimedtohavemorescruples:ithad

designatedtheareaa “no-firezone”,wherecivilianscouldsafely

gather.Nonetheless,it continuedtoshellthebeachmercilessly.

Theunwarnedthata humanitariandisasterwasunfoldingand

urgedthegovernmenttodeclarea ceasefire,tonoavail.Inthe

endresistancecrumbledandthearmytookcontrol.Butthe

beach wasleft piledwith bodies, with more

floatingintheadjacentlagoon.Thenumberof

civilianswhodiedinthefinalphaseofthewar,

theunconcludedyearslateraftera longinvesti-

gation,wasprobablyinthe“tensofthousands”.

GotabayaRajapaksa,themanwho,assecre-

taryofdefence, presidedoverthis horrifying

episode,hasjustbeenelectedpresidentofSri

Lanka (see Asia section). To Sinhalese Bud-

dhists,about70%ofthepopulation,heisa hero.Afterall,the

militiahedestroyedwasappallinglycruelandbloodthirstyand

hadtormentedTamilsasmuchas,ifnotmorethan,otherSri

Lankans.Tothe15%orsoofthepopulationthatisTamil,how-

ever,MrRajapaksa’sendsdonotjustifyhismeans.InJaffna,the

biggestTamilcity,hewonjust6%ofthevote.

MrRajapaksatriedtoreassureminoritiesduringtheelection

campaign.Hevisiteda mosque,forexample,ina soptothe10%

ofSriLankanswhoareMuslim.ButSinhalesegroupswithwhich

heiscloselyalignedkeptupa steadyanti-Muslimdiatribe,espe-

ciallyaftersuicide-bombingsatseveralchurchesandhotelsat

Easterkilledmorethan 250 people.Tellingly,theonlydistrict

whereTamilsarea minoritythatMrRajapaksafailedtocarrywas

Ampara,whereMuslimsarethebiggestgroup.

Whenaskedaboutthepast,MrRajapaksaparries,sayingthat

it ismoreimportanttothinkaboutthefuture.Peopleinhiscircle

admitthathemademistakes,butpromisethathewilldothings

differently this time. Manybusinessmen, in particular, are

thrilledattheoutcomeofthiselection.Theyarehopingfora per-

iodofdecisiveeconomicmanagement,afterfouryearsofbick-

eringanddithering.

It maybethatMrRajapaksaprovesa goodeconomicmanager,

althoughtherecordofhisbrother,Mahinda,whowaspresident

from 2005 to 2015 andwhomGotabayaintendstoappointas

primeminister,wasmixed.SriLankacertainlyneedstogeton

withpost-warreconstruction,whichhasproceededdistress-

inglyslowlyandwouldbenefitfroma moreeffi-

cient,drivengovernment.

Forthemostpart,though,SriLankadoesnot

need a strongman. It has been remarkably

peacefulfor adecade,despitethecarnage at

Easter.If thereisa pressingconcernaboutsecu-

rity,beyondthehuntforterrorists,itisthatthe

sortofSinhalesenationalistsatwhomMrRaja-

paksahasbeenwinkingwillresorttomobvio-

lence.Anti-Muslimriotshavetakenplacenotonlyafterthe

bombingsthisyear,butalsoin 2014 and2018.

TheelectionresultsshowthatSriLankaisstillethnicallypo-

larised.IfMrRajapaksareallywantstodemonstratethatheisa

changedman,heshouldstartbyreassuringminorities.Itisen-

couragingthathehassaidheseeshimselfaspresidentforallSri

Lankans,notjustthosewhovotedforhim.Butforeverygesture

ofunity,therehasbeena contrary,sectarianone.Forexample,

MrRajapaksachosetobesworninata Buddhisttemple.

Theendofthewar,howeverbloody,heldoutthehopeofa

peacefulandprosperousfutureforallSriLankans.Itwouldbe

tragicifMrRajapaksaunderminedhisownachievementbyin-

flamingthedivisionsofthepast. 7

Oh brother

Gotabaya Rajapaksa is a strongman. Sri Lanka needs a bridge-builder

Sri Lanka’s new president

T

he health-caresystem in America has long suffered from

two grave problems. The first is that not enough people have

reasonable access to medical treatment if they fall ill. President

Barack Obama tackled this with his landmark reforms in 2010,

which succeeded in extending coverage to some 20m Americans

who previously lacked insurance. Mr Obama cut a deal with

America’s powerful health-care lobbies and built a grand co-

alition for reform that included hospitals, insurers and Big

Pharma. The law was passed after an epic battle in Congress.

Unfortunately, since that success the second problem—exor-

bitant costs—has spiralled even further out of control. Health

spending has risen from 17.3% of gdp before Obamacare was

passed to 17.9% today. The average figure for rich countries is 9%.

Now President Donald Trump is aiming to slay the monster. On

November 15th he announced plans to require hospitals and in-

surance firms to disclose the true prices they charge. More trans-

parency is a vital step in ending the health-care racket. But the

plan will not work unless there is also a drive to boost competi-

tion in rigged local hospital markets.

Mr Trump has correctly identified a big villain behind health-

care cost inflation, and it is not Big Pharma. Hospitals account

for over 30% of health-care spending, whereas drugs account for

Sunshine is a partial disinfectant

America’s hospitals are a racket. They need a dose of transparency—and tougher antitrust action, too

American health care