Misfires can be caused by a multitude of issues so no, you cannot always assume it's a cam synchro issue. A bad or leaking fuel injector, bad plug, bad wire, bad coil pack, ECU issue, vacuum leak, bad head gasket, cracked head, bad valve, bad valve spring, carbon buildup, bad valve seal, and on and on and on...
The engine can actually run just fine without the cam sync, it's mearly there for improved feedback to the computer to help with emissions. The engine can run on the crank sensor alone. Not that you can just remove it because as previously stated, it drives the oil pump.
As for making sure the cam synchro is being oiled, they typically begin to squeak when the bushing is failing. Replacing it before it seizes is the key. There are some articles in the tech section about replacement, and how to prevent failures.