Those individuals include Baltimore Mayor Catherine Pugh , a Democrat whose cozy ties to UMMS began when she was a state lawmaker, sitting on a committee that funded the system even as she sold her self-published children’s books exclusively to that system for hundreds of thousands of dollars. Confronted by the Baltimore Sun, Ms. Pugh assumed a Trumpian tone, denouncing the inquiry as a “witch hunt.” Under fire, however, she also resigned from the UMMS board and returned $100,000 of her ill-gotten gains — for sales of her latest book, which was apparently never delivered.

She then refused to disclose her personal or tax records because, she said, she “did everything right.” Question: If the mayor “did everything right,” then why not produce the documents?

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This is political sleaze pure and simple. Yet Ms. Pugh’s double-dealing differed from that of several of her fellow board members only in that she served in elective office. Somehow, in the apparent absence of legislation or ethical standards governing the health system’s board, its members got the idea that serving on the board gave them license to profit from their connections. In all, according to the Baltimore Sun, about one-third of the appointed board members received payments from UMMS arising from contracts with their businesses — ranging from pest control to civil engineering. Other than Ms. Pugh, two other board members have resigned, and UMMS has asked four others to take voluntary leaves of absence while their business arrangements are reviewed.

The conflict of interest is obvious; it should not have needed explaining to board members. Did health-system officials award contracts to board members’ firms that would otherwise have gone to more qualified bidders? Did board members avert their gaze from lax contracting rules that resulted in generous spending on their own companies?

Ms. Pugh’s case is egregious. The medical system, on whose board she has served since 2001, paid her $500,000 during this decade for the purchase of 100,000 copies of her “Healthy Holly” books, which promote healthy lifestyles for children. What’s worse, the system reported some of the payments as “grants” to Ms. Pugh’s company, Healthy Holly LLC, in what looks like an attempt to obscure the transactions. In the nonprofit world, grants are generally made to other charitable outfits, not for-profit firms such as Ms. Pugh’s company. The books were supposed to be distributed in Baltimore public schools, but thousands of them remain in a warehouse, packed in boxes.