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Bad enough that Cook County officials pretended to save taxpayers money with a "hiring freeze" during which they added 2,700 new employees. Bad enough that the county's oversight of a program to assist women- and minority-owned businesses was so slipshod that nobody realized that the African-American woman ostensibly running one politically connected firm had been dead for 14 months. Cook County's latest scandal is more infuriating, more dangerous to needy people who rely on the county for health care, than either of those case studies from Mismanagement 101. Sunday's Tribune disclosed that county officials paid more than 100 of their workers $50,000 or more in overtime last year. One county nurse with a salary of $92,793 also earned $187,548 in overtime pay. County government paid $76.7 million in overtime last year--$55.7 million of it to Health Department workers and $12 million to sheriff's employees. This is the same government that, until reformers on the County Board prevailed, tried to raise taxes to cover a $73 million budget shortfall for 2005. In essence, the failed tax increases would have further enabled the county's wasteful habit of paying time-and-a-half for ordinary work. (A county spokeswoman says overtime hours fell 6 percent last year. She blamed the higher tab for overtime on the county's rising pay scales. That's yet another scandal.) Try to imagine managers at your workplace wasting money by paying overtime premiums for routine work year after year. Imagine they repeatedly had promised to rein in their runaway overtime costs while doing squat. Now imagine how many of your bosses would be fired. Last year, 57 county workers doubled their salaries thanks to overtime. That list includes six security guards, two ward clerks at Stroger Hospital and a janitor at Provident Hospital. Yes, there is a nursing shortage. But a guard shortage? A ward clerk shortage? A janitor shortage? Let's call this what it is: a betrayal of county health care for poor citizens. Board President John Stroger forever tries to muddle the genuine importance of Cook County's health mission with the wasteful way his managers provide it. "Anybody who wants to try to destroy the health-care system of this county has got me to fight," Stroger huffed in February when the County Board reformers demanded operating efficiencies to better serve the poor. Stroger should have blasted the real enemies of good care for the poor: politicians who have larded the health payroll with patronage hires. The neediest victims of this egregious mismanagement aren't taxpayers. The neediest victims are poor people who could receive better, and more timely, treatment. County Board member Michael Quigley correctly notes that disclosure of the county's reckless overtime pay will further hurt poor citizens. Stroger loves to blame politicians and bureaucrats in Washington and Springfield for not giving Cook County more money. What will those politicians and bureaucrats think the next time Illinois congressmen or Chicago-area legislators come begging more money for Cook County? Those folks in Washington and Springfield likely will ask: You want more tax money for a government that would rather featherbed its payroll with patronage hacks than hire more doctors to treat patients? That repeatedly lets workers double their salaries in costly overtime for routine work? You want money for that? County health boss Dr. Daniel Winship has had less than a year to undo the mess he inherited. He says managerial changes and new hires in clinical areas are reducing overtime in this fiscal year. He clearly understands that the County Board has demanded that he wring more efficiencies from the vast health bureaucracy. Stroger's little lambs on the County Board love to posture as defenders of health care for the poor. The lambs should be in a public furor about this overtime scandal. Year after year, they've tolerated the squandering of scarce resources at the expense of needy patients for whom Cook County is the caregiver of last resort.