Regardless of what happens to health care, is a factually compromised public discussion of issues a threat to democracy?
Now, we're back to perhaps the thing that people are most upset about. For them, democracy is all about a marketplace of ideas: democracy works when disinterested citizens openly consider all options, and the best ideas are supposed to win.
All kinds of things flow from this idea of democracy. In campaigns, negative advertising is bad, candidate debates are good (but never quite good enough, since the questions never quite pin those slimy politicians down). In campaign finance, pretty much any kind of private funding is bad. Voters should know the issues, and vote based on their analysis of the issues, certainly not because they belong to an interest group or a political party.
This good government (or Goo Goo) form of democracy is, in fact, threatened by misinformation.
But Goo Goo democracy is, I would argue, a hopeless idea in the first place. Sure, it has no defense against lies corrupting open debate, but that's not even the half of it. Just a bit of a tour through what's known about voters shows that they don't know what they're talking about much of the time, don't seem to care about public policy very much, and to the extent that they do get involved they learn only what they need to know to support their group or party prejudices. That is, not only do people vote by party, but they "know" things by party, too (here's just one example). It's not just Kids These Days; it goes back as far as we can study it.
So is democracy doomed? Not at all.
Goo Goo democracy is doomed, or at least that sort of democracy is and always was a false idol at best. Real-life democracy, however, can thrive. Real life democracy accepts that people (often, at least) act in groups. People use groups -- party, primarily, but other groups too -- as good-enough shortcuts. I don't have to learn anything about health care, because if I trust the (whichever) party in general, I can just trust them on this issue. There's nothing sinister about that. I have interests, or perhaps general preferences, and as long as I more-or-less align them with the right group, I'm going to be fine. It's great (really, no sarcasm intended -- it's how I write this blog, too) that there are individuals out there belonging to "no party or clique" and can analyze policy without regard to self-interest, but very few of us have time to learn the intricacies of urban planning and climate change and macroeconomics and whether the F-22 is really a boondoggle and health care and missile defense and whether cutting taxes does or doesn't lower revenues and Pakistan/Taliban/Kashmir/Afghanistan/etc. The hundreds, literally, of other issues.
And in the aggregate, the kind of democracy we do have seems to work pretty well. In elections, we don't actually express our issue positions (since most of us don't really hold positions on most issues), but many of us actively rally to the camp of our groups, and enough of the rest switch sides in ways that more-or-less effectively punish gross incompetence, or at least give incumbents strong incentives not to be grossly incompetent. Outside of elections, we support our groups (whether narrow interest groups or the larger parties) and those groups stick up for us in policy debates -- not (necessarily) the public debate that no one pays much attention to, but the real bargaining and power plays in Congressional committees, executive branch agencies, the White House, and courtrooms. It's by no means a perfect system (among the many potential problems would be that there's no guarantee that groups have influence in proportion to their strength in the population), but the way to judge it is within its own terms, not by whether the quality of public debate is good enough.
Public opinion in the aggregate does play a role, since politicians are (fortunately) massively risk-averse, and easily scared by polling data. It's an indirect role, however. And it rarely, if ever, has anything to do with an engaged public actively, and with dispassionate neutrality, debating the issues.
One last thing...none of this is to say that individuals are irrelevant. To the contrary: in my reading of James Madison, the whole system is designed to encourage interested individuals to get involved. There is no cap to the influence that those individuals who do get engaged and active can have in the American system, and as individuals we don't have to be simply the sum of our interests and group identifications. But the system is also designed to allow those who are too busy (or even too lazy) to have a say, too, through the groups that the activists among us create and keep going.
If looked at from this point of view, we can ask: does it matter a lot if there's misinformation out there? And the answer is: no, not really. No one in Congress is acting on the misinformation (yeah, it's likely that some GOP Members of Congress believe their own nonsense, but they weren't going to vote for health care reform regardless). I doubt if very many interest group leaders are acting on misinformation. Certainly the major players in the debate -- the doctors, hospitals, health insurance companies, the pharmaceuticals, large and small employers groups, the unions, the organized seniors groups -- they don't think that this is about killing granny and Stephen Hawking. Nor is it very likely that wild accusations having nothing to do with the real legislation is going to swing so many Democrats and other supporters of the president that the polls will bury the bill.
The health care bill may or may not thrive, but nutty lies about it are not a sign that the republic cannot hold. Madisonian democracy is much stronger than that.