Many people are horrified, and rightly so, by what passes for leadership in today’s Washington. And it’s important to keep the horror of our political situation up front, to keep highlighting the lies, the cruelty, the bad judgment. We must never normalize the state we’re in.

At the same time, however, we should be asking ourselves how the people running our government came to wield such power. How, in particular, did a man whose fraudulence, lack of concern for those he claims to care about and lack of policy coherence should have been obvious to everyone nonetheless manage to win over so many gullible souls?

No, this isn’t a column about whatshisname, the guy on Twitter, who’s getting plenty of attention. It’s about Paul Ryan, the speaker of the House.

I’m writing this column without knowing the legislative fate of the American Health Care Act, Mr. Ryan’s proposed Obamacare replacement. Whatever happens in the House and the Senate, however, there’s no question that the A.H.C.A. is one of the worst bills ever presented to Congress.

It would deprive tens of millions of health insurance — the decline in the number of insured Americans would be larger than what would result from simple repeal of Obamacare! — while sharply raising expenses for many of those who remain. It would be especially punitive for lower-income, older, rural voters.

In return, we would get a small reduction in the budget deficit. Oh, and a tax cut, perhaps as much as $1 trillion, for the wealthy.

This is terrible stuff. It’s made worse by the lies Mr. Ryan has been telling about his plan.

He claims that it would lower premiums; it would actually increase them. He claims that it would end the Obamacare death spiral; there isn’t a death spiral, and his plan would be more, not less, vulnerable to a vicious circle of rising premiums and falling enrollment. He claims that it would lead to “patient-centered care”; whatever that is supposed to mean, it would actually do nothing to increase choice.

Some people seem startled both by the awfulness of Mr. Ryan’s plan and by the raw dishonesty of his sales pitch. But why? Everything we’ve seen from Mr. Ryan amid the health care debacle — everything, that is, except the press coverage — has been completely consistent with his previous career. That is, he’s still the same guy I wrote about back in 2010, in a column titled “The Flimflam Man.”

I wrote that column in response to what turned out to be the first of a series of high-profile Ryan budget proposals. While differing in detail, all of these proposals share a family resemblance: Like his health plan, each involved savage cuts in benefits for the poor and working class, with the money released by these cuts used to offset large tax cuts for the rich. All were, however, sold on false pretenses as plans for deficit reduction.

Worse, the alleged deficit reduction came entirely from “magic asterisks”: claims about huge savings to be achieved by cutting unspecified government spending, huge revenue increases to be achieved by closing unspecified tax loopholes. It was a con job all the way.

So how did Mr. Ryan reach a position where his actions may reshape the lives of so many of his fellow citizens, in most cases very much for the worse? The answer lies in the impenetrable gullibility of his base. No, not his constituents: the news media, who made him what he is.

You see, until very recently both news coverage and political punditry were dominated by the convention of “balance.” This meant, in particular, that when it came to policy debates one was always supposed to present both sides as having equally well-founded arguments. And this in turn meant that it was necessary to point to serious, honest, knowledgeable proponents of conservative positions.

Enter Mr. Ryan, who isn’t actually a serious, honest policy expert, but plays one on TV. He rolls up his sleeves! He uses PowerPoint! He must be the real deal! So that became the media’s narrative. And media adulation, more than anything else, propelled him to his current position.

Now, however, the flimflam has hit a wall. Mr. Ryan used to be able to game the Congressional Budget Office, getting it to produce reports that looked to the unwary like proper scores of his plans, but weren’t. This time, however, he couldn’t pull it off: The C.B.O. told the devastating truth about his plan, and his evasions and lies were too obvious to ignore.

There’s an important lesson here, and it’s not just about health care or Mr. Ryan; it’s about the destructive effects of false symmetry in reporting at a time of vast asymmetry in reality.

This false symmetry — downplaying the awfulness of some candidates, vastly exaggerating the flaws of their opponents — isn’t the only reason America is in the mess it’s in. But it’s an important part of the story. And now we’re all about to pay the price.