WASHINGTON — A year ago President Obama strolled confidently into the garden of good and evil, bit deeply into the apple and created the mess he and congressional Democrats are in now concerning health insurance reform.

Only a few heady weeks into his presidency, Obama called his first White House health care summit. It was not with those who got him elected, folks from the neighborhoods, the universities, the clinics and officials from hard-pressed state and local health agencies.

Thinking he was still in Chicago, Obama blithely muscled such non-entities aside and settled in with silk-suited brass from the health insurance trade, the hospital conglomerates and the prescription drug business.

With trusted Chicago aides at his elbow, Obama made an amoral deal with the drug manufacturers that has poisoned everything that happened since. He had a debt to pay. The drug makers had donated tens of millions to his Senate and presidential campaigns.

Just after this summit, Obama secretly promised the Rx people that there would be no government jaw-boning with the industry to get lower prices for seniors and others. Obama also promised them there would be no drug importation from Canada and other reliable foreign countries.

This, after then-candidate Sen. Obama promised his administration would enter into talks for lower prices and would bring cheaper but identical products in from Canada. As a U. S. senator and presidential candidate, Obama voted for both.

I am indebted to reporters Tom Hamburger, who broke the story last year about this amazing turnabout, and Paul Blumenthal, who recently added important details. Obama’s 180-degree switch sent a signal to all legislators with close ties to special interests. Obama had campaigned on transparency and chasing lobbyists out of town. Now, it all moved behind closed doors, just as in the ferment over Hillary Clinton’s failed health care proposals 15 years before. The lessons then and now: Don’t trust the people.

On April 15, 2009, there was a secret meeting at the Democratic Senate Campaign Committee at which the drug industry outlined its advertising campaign for health insurance reform. Another part of the $80 billion deal was filling in some, but not all, of the doughnut hole in Medicare Part D.

Seeing that Obama didn’t believe his own campaign rhetoric about transparency, the Senate Finance Committee began its secret talks on what constituted health insurance reform. Max Baucus, D-Mont., is chairman. Charles E. Schumer, D-N. Y., is a prominent member. Baucus emerged on June 20 and called Obama’s unsavory deal with the drug industry “a once-in-a-lifetime opportunity.” It certainly wasn’t for sick people with limited incomes.

Not long afterward, Senate Democrats got all wobbly about the public option that passed the House. This would be a government-supervised and subsidized insurance program. It would have been the best yardstick by which private health insurance costs could be measured and controlled. On Oct. 28, Sen. Joe Lieberman, D-Independent, said he would block any bill that contained the public option. Many senators, awash in insurance industry money, shed crocodile tears at the demise of the public option.

Obscured in quarrels over details is the collapse of public trust.

Now, instead of cost control, we are arguing over a symbol: The idea that Democrats need to pass something, even though it won’t produce better health care.

Nothing better symbolizes that special hell into which Obama’s dealings sent health care than a rule being shaped by Rep. Louise M. Slaughter, D-Fairport, and chairwoman of the Rules Committee. She would have the House symbolically approve the Senate bill that would cost New York taxpayers $1 billion a year in added Medicaid costs. Part of the money subsidized payoffs to Vermont, Nebraska and Michigan to buy their senators’ votes last Dec. 24.