Heat the oil: In a large pot or Dutch oven, heat 2 tablespoons of extra virgin olive oil over high heat.
Sear the pork: Season 2 to 3 pounds of pork (loin, chops, ribs, or neck bones) with kosher salt and black pepper. Sear in the pot until nicely browned on all sides, about 5 to 7 minutes. Remove from the pot and set aside.
Cook the onions: Lower the heat to medium. Add 1 finely diced onion to the pot and sauté until soft, about 5 minutes.
Add garlic and chili flakes: Add 5 cloves of thinly sliced garlic and a pinch of red chili flakes. Cook for an additional 2 minutes, stirring frequently.
Stir in tomato paste: Add 3 tablespoons of tomato paste (optional) and cook for 1 to 2 minutes, stirring to combine.
Add tomatoes and herbs: Add 2 (28-ounce) cans of whole peeled or crushed tomatoes, 2 bay leaves, and 1 tablespoon of minced parsley. Season with salt and pepper. Fill one of the empty tomato cans with water and add it to the pot. Stir to combine.
Simmer the sauce: Bring the sauce to a boil. If using whole tomatoes, use a wooden spoon to break them apart. For a smoother sauce, use an immersion blender, but remove the bay leaves first.
Add the meats: Return the seared pork to the pot, along with 1 ½ pounds of Italian sausage and 16 to 20 cooked meatballs. Reduce heat to low and let the sauce simmer for about 3 hours, stirring every 20 minutes to prevent burning.
Taste and adjust: After 3 hours, check the sauce for seasoning. Add a pinch of sugar if needed to balance the acidity. Taste and add more salt or pepper as desired.
Prepare to serve: Remove the bay leaves and any bones from the pork. Use a slotted spoon to transfer the meats to a large platter. Toss al dente pasta with a little bit of the sauce.
Serve: Serve the pasta with the platter of meats on the side. Pass a bowl of grated Pecorino Romano cheese and a bowl of ricotta cheese at the table.