The health-care debate has gone crazy. Last week, in New Hampshire, a child stood outside the president's town-hall meeting holding a sign that read, "Obama Lies, Grandma Dies." On the road outside the meeting, a man held up a sign that appeared to support the bloodshed of "tyrants," while sporting a pistol (legally) strapped to his thigh.

What have we come to when an American citizen is bold enough to do something like that? And where are we going?

Health-care reform is an enormously complex, vitally important issue, but it has become all but impossible to hold a civil discussion about it. These town halls have degenerated into ugly, obnoxious town hells.

At that New Hampshire rally, Obama denounced "special interests" for trying to derail health-care reform. Said the president, "They use their political allies to scare and mislead the American people. . . . We can't let them do it again."

It's not so simple. The unhinged emotional dramas that threaten to drown deliberative democracy in a sea of rage are nothing new — and by no means limited to right-wing populists. Remember ACT-UP, the 1980s AIDS protesters, who pioneered high-profile guerrilla protests, including shouting down public officials? For a generation on many college campuses, conservative speakers have had their speeches disrupted by organized hecklers determined not to let them make their case.

In a startling irony, anti-Obama conservatives have gone from denouncing the organizing strategies of the late Chicago leftist Saul Alinsky to taking up Alinsky tactics themselves. Journalist David Weigel reported last week that tea party and town hall activists are unapologetically cribbing from Alinsky's "Rules for Radicals." One conservative activist, quoting one of Alinsky's rules, urged followers to "freeze it, attack it, personalize it, and polarize it."

It works. We're now talking not about health care reform, but these berserk meetings. Television magnifies the protests' rhetorical power, further distorting the debate. Many people go to these events convinced that their president and members of Congress are capable of doing unspeakable things. Others watching at home, unnerved by the hysteria, might wrongly conclude that any criticism of the Obama proposal is to make common cause with hotheads.

In the end, nothing gets done because straightforward discussion and debate has become impossible. Which, per Alinsky, is probably the point.

"But you don't understand," they say. "People are angry." Since when does anger justify itself? Since when did we turn into people who believed our anger entitles us to act like barbarians?

A related trend in our political culture is the idea that the stakes in any given battle are so high that extremism in defense of one's cause is no vice. Supreme Court nominations (at least since the Bork era), Social Security reform, immigration reform these and other controversial matters become so charged with emotional maximalism that folks come to think of the other side as not only wrong, but evil.

Who benefits? Not the American people, who recognize that the current health care system needs reform, but have legitimate questions about how to go about that. How will we pay for meaningful reform? How can we preserve the free market in health care, within reason, if government takes a larger role in the system?

People have a right to know. A raucous minority of loudmouths is taking it away from them — and with it, the opportunity to change an unsustainable system. It's becoming increasingly apparent that what's really broken is not only our health care system, but our approach to democracy.