There's nothing new under the sun, especially when it comes to the frothing at the mouth right-wing rage over health care reform. But thanks to the 24/7 media's transformation of politics into just another form of entertainment, delusional Birthers, deceitful Deathers, raging Teabaggers and town hall intimidators are dominating press coverage of the debate. And it's all a recurring symptom, Rick Perlstein argues in the Washington Post, of a nation in which "crazy is a preexisting condition."

In his instant classic Nixonland, Perlstein documented how Richard Nixon, "a serial collector of resentments," fanned the flames of racism, anti-communism and the budding culture war not only to take power in his time but to help produce a bitterly divided America in ours. Now in his Washington Post op-ed, Perlstein makes clear that we've been here before.

The repeated outbreaks of "black helicopters" in the 1990's, the National Indignation Convention in 1961, cries that the Civil Rights Act would "enslave" whites and countless other episodes of seeming conservative madness, Perlstein reminds us, result from the combustible combination of authentic fear and manufactured outrage:

So the birthers, the anti-tax tea-partiers, the town hall hecklers -- these are "either" the genuine grass roots or evil conspirators staging scenes for YouTube? The quiver on the lips of the man pushing the wheelchair, the crazed risk of carrying a pistol around a president -- too heartfelt to be an act. The lockstep strangeness of the mad lies on the protesters' signs -- too uniform to be spontaneous. They are both. If you don't understand that any moment of genuine political change always produces both, you can't understand America, where the crazy tree blooms in every moment of liberal ascendancy, and where elites exploit the crazy for their own narrow interests.

But Perlstein's cautionary tale is not merely one of the more things change, the more they stay the same. In its pursuit of entertainment over objective truth and conflict over common sense, he suggests, today's media environment rewards extremist claims and behaviors it once shunned:

It used to be different. You never heard the late Walter Cronkite taking time on the evening news to "debunk" claims that a proposed mental health clinic in Alaska is actually a dumping ground for right-wing critics of the president's program, or giving the people who made those claims time to explain themselves on the air. The media didn't adjudicate the ever-present underbrush of American paranoia as a set of "conservative claims" to weigh, horse-race-style, against liberal claims. Back then, a more confident media unequivocally labeled the civic outrage represented by such discourse as "extremist" -- out of bounds.

The tree of crazy is an ever-present aspect of America's flora. Only now, it's being watered by misguided he-said-she-said reporting and taking over the forest. Latest word is that the enlightened and mild provision in the draft legislation to help elderly people who want living wills -- the one hysterics turned into the "death panel" canard -- is losing favor, according to the Wall Street Journal, because of "complaints over the provision."

And so it goes. In 2009, the woman who clobbered Adlai Stevenson with a picket sign 46 years earlier would have ended up on cable news. As for the future prospects for health care reform legislation, Perlstein looked back. "Good thing our leaders weren't so cowardly in 1964, or we would never have passed a civil rights bill," he laments, "because of complaints over the provisions in it that would enslave whites."

(This piece also appears at Perrspectives.)