The way the debate over health care has played out in this country makes me wonder if the United States is coming to resemble the Middle East.

In the Middle East, and in Pakistan, the public views the world through a haze of conspiracy theories. No scenario is too outlandish to believe, and many fill the airwaves and the local press. Facts are largely absent, or buried under mountains of fiction.

You may recall one of the most egregious of such theories: that Israel carried out the 9/11 attacks, as "proved" by the fact that Jews didn't show up for work at the twin towers that day (a ludicrous lie). However, I was assured that this claim was true by several very sincere Saudi graduate students in Riyadh in the spring of 2002. I was also assured by a leading Pakistani journalist in May in Islamabad that America and India were conspiring to dismember his country.

I used to feel a sense of relief when I returned from a trip to those regions and picked up an American newspaper. But when I see the current health-care debate derailed by false charges about "death panels" - charges that persist no matter how often they're refuted - I begin to get nervous. When the blogosphere seethes with false claims President Obama isn't a citizen, I being to wonder:

Could a conspiracy culture take root here?

I understand why Arabs and Pakistanis are susceptible to such fantasies. In societies ruled for decades by autocrats, ordinary people have little control over their fate and no access to solid information. Yet they are anxious for explanations about their economic problems, or their country's lack of development progress.

Conspiracy theories that blame foreigners or minorities for every ill and are propagated by political or religious leaders fill the vacuum. Government-controlled media promote them, and privately owned media print them because they sell. Brave journalists who try to write truth are risking their livelihood, or their lives.

Of course, "the paranoid style" is not unknown to American politics, as Richard Hofstadter wrote in his famous 1964 essay. Rather, it is "an old and recurrent phenomenon" linked with discontented and suspicious groups at turbulent periods in our history.

Among Hofstadter's examples: the anti-Masonic movement, the anti-Catholic movement, the theories of some populist writers who constructed "a great conspiracy of international bankers," and - on both sides of the racial divide - the White Citizens' councils and the Black Muslims.

Hofstadter also cites the anticommunist conspiracy theories of Sen. Joseph McCarthy in the early 1950s, who denounced "a conspiracy of infamy" by which "men high in this government are concerting to deliver us to disaster."

In more recent decades one could dismiss American conspiracy theorists as isolated from the mainstream: think small groups operating in Montana or in Deep South enclaves. Or those, including a just-resigned minor White House official, who believed the Bush administration let 9/11 happen as a pretext for war.

In the age of the Internet, however, things have dramatically changed.

Large numbers of Americans now turn to ideological Web sites for their news, or to (mostly conservative) radio talk shows. Unverified opinions, rumors, and emotions are served up in lieu of facts, but are often accepted as gospel. Meantime, the mainstream media, which still lays out facts, including on health care, is vilified by left and right and economically battered.

Add to this brew, a widespread fear of the future bred by the economic crisis, and a growing frustration with government (fanned by blogs and talk shows.) Further add the fact of our first African American president, who, although elected by a majority, stirs resentment and rage among some.

Such a climate is the perfect incubator for conspiracy theories. What's particularly disturbing is to see prominent national politicians encourage the politics of paranoia - as Sarah Palin did with grossly untrue claims about death panels and Sen. Chuck Grassley did with talk of "pulling the plug on grandma." There's enough misinformation out there, without legislators adding to the furor.

Conspiracy theories thrive in tough times, but we've never before lived in an era where the Internet can send them viral. I have seen how a conspiracy culture distorts politics in the Middle East and Pakistan. Believe me, you don't want that here.