By Evan Falchuk

The other day, Ezra Klein of the Washington Post wondered if the reason health care reform was running into so much trouble was because of a sort of conspiracy.  According to Klein, it was the forces of the “health care industry,” with their economic and political power, blocking reform, like they had for decades.

Today we can see how very deep this conspiracy really is.

This deep:

The drug industry, which has held off running ads until officials sign off on the final reconciliation bill, is growing more comfortable with the emerging legislation and is preparing a substantial pro-reform ad buy in 43 Democratic districts, according to a senior industry source. . . . The movement should also help appease the White House, which has been leaning on the industry to provide Democrats air cover, according to industry sources.

Now we’re talking about an impressive conspiracy.  An industry segment that represents a great deal of U.S. health care spending is supporting the reform bills.  You know, it’s just what you’d expect them to do to throw you off their path, right?

But it gets worse.  Andrew Sullivan notes that Intrade, the web-based prediction market puts the reform plan at about a 70% chance of passing, while former senior Bush adviser Keith Hennessy says it has a 2 in 3 chance of passing.  So whatever reform plan is actually on the table may well become law later this week.  Some conspiracy.

But even if it does, reform’s deep unpopularity won’t go away.  The mistake is casting about for enemies to blame for this.

Like a poor salesman, who blames his customers for being too dumb to understand his product, reform advocates seem unable to see how they have created the problems they face.  From the beginning they failed to understand how seriously Americans react to anything they think will affect their hard-earned health benefits (I’ve blogged about this problem for a long time, like here, here and here).  It’s surprising that politicians have never understood this, since they make a living understanding what people want.  But there it is.

The decision to outsource reform to Congress guaranteed that the legislation would be a massive collection of things that no one could ever simply or coherently explain.  The year or more of new proposals, new debates, competing plans all just kept stoking public anxiety around health coverage.  No one knew what would happen to their benefits if a bill were passed.  It all culminated — or so most people thought — in the shocking election of Massachusetts Republican Scott Brown to the Senate in January.  But it still goes on.   And what is now a sort of zombie version of health care reform may, in a final weird twist, pass the House without being voted on, and head to the President’s desk.

So, yes, American health care is too expensive, too unfair, and very much in need of help.  The tragedy is that, in doing too much talking and not enough listening, reformers are losing their best chance to do something sustainable and good.