There is absolutely, positively no doubt that Democrat Todd Stroger, had he publicized his diagnosis of prostate cancer, would not have been his incapacitated father's replacement as Cook County Board president nominee in 2006. Nor, had he done so later, would he have been elected.

John Stroger had a stroke in March, before he won the Democratic primary. Todd Stroger was diagnosed in April, but he concealed that information, and the Cook County Democratic Central Committee chose him to run in August.

In the November election, Republican County Commissioner Tony Peraica ripped Stroger for his method of appointment and his inexperience and called for reform in county government. In a turnout of 1,263,539, Stroger topped Peraica by a narrow 94,457 votes, with 53.7 percent of the total cast. Had Stroger's health issue subterfuge surfaced, Peraica likely would have won.

Looking ahead to 2010, when Stroger's term expires, there is absolutely, positively no doubt that Stroger's credibility will be the overriding issue -- but not necessarily on the matter of his illness. Instead, it will be whether he has fulfilled his 2006 promise to cap county spending, avoid tax hikes and reform the county's hiring process, which is the subject of a federal investigation.

As prostate cancer is treatable and curable, there is every expectation that Stroger, age 44, will run for re-election, and there is absolutely, positively no doubt that there will be a credible field of opponents, among both Democrats and Republicans.

Democratic county Commissioners Forrest Claypool, Mike Quigley and Larry Suffredin are angling to run. Claypool opposed John Stroger in the 2006 primary, and his reform message was developing momentum, but Stroger's stroke put the contest into limbo. The incumbent got a huge outpouring of votes from the black community, and sympathy votes from many whites. Stroger won by 318,634-276,682, a 41,952-vote margin, getting 53.5 percent of the vote. Claypool definitely is running again in 2010. Quigley announced in 2005 that he was running but then withdrew and endorsed Claypool. He won't defer to Claypool in 2010.

Claypool represents a Northwest Side county board district, while Quigley is from the Lakefront and Suffredin from the North Shore. All are white. If two or more run as a reformer, then Stroger wins easily.

Peraica wants a rematch, but Republican county Commissioner Liz Gorman, who like Quigley stepped aside in 2006, won't do so in 2010. She now is the Republican county chairman, and she and Peraica detest each other. A vicious primary looms.

Various newspapers have editorialized about the need for "full disclosure" of candidates' health. Does the public have the right to know if a potential or current elected official is sick or dying? The Stroger clan has perfected the art of non-disclosure. Stroger's stroke, 2 weeks before the 2006 primary, didn't derail his renomination, but secrecy surrounding his condition and potential recovery did delay his replacement until the latest possible moment.

Todd Stroger, then the alderman of his dad's South Side 8th Ward, just south of Hyde Park, was the obvious successor, for several reasons:

First, the ward's "Stroger Machine," composed of at least 1,200 county and city job holders, has long been a bulwark of support for the "Daley Machine." Without a Stroger to protect those jobs, the ward's machine would crumble and the 3,000-plus county job holders in other predominantly black South Side wards would be adrift and not cogs in the Stroger/Daley machine. Mayor Rich Daley needs a visible, powerful black politician to provide tangible support.

In the 2007 mayoral election, Daley won the 8th Ward by 4,450-2,875 over Circuit Court Clerk Dorothy Brown, who lives in the area. Daley carried all 20 black-majority wards.

Second, Todd Stroger would be a compliant board president, acceding to instructions from the mayor's brother, county Commissioner John Daley, the board Finance Committee chairman. Stroger has not disappointed.

In the 2006 campaign Stroger was derogated as an "amiable dunce" and called the "Toddler." Peraica chastised him as a "puppet" of the mayor and warned that if Stroger won, the county's existing $500 million budget deficit would necessitate a 2007 tax hike. It didn't happen.

John Stroger had a 9-8 majority on the county board. Under Todd Stroger, the 2007 zero-growth budget of $3 billion passed 13-4, with a 17 percent across-the-board cut in county offices. Of the county's 23,383 jobs, 2,193 positions were not budgeted and 1,700 workers were eliminated, including 129 sheriff's police officers, 102 state's attorney's office prosecutors and public defenders, 134 employees in the clerk's office and 230 courtroom deputies. Infertility and plastic surgery treatment at Stroger Hospital also was terminated. Public safety spending declined 3 percent and health care spending declined 8 percent (with 14 health clinics closed and 176 nurses and 81 physicians terminated), while spending on pensions was up 19 percent. Those cuts saved $350 million, and a refinance of pension bonds saved $150 million. The county property tax levy remained stable at $720 million, and overall spending was $112 million less than in 2006. Stroger kept his promise.

Had this been accomplished while Peraica was president, a thunderous hue and cry would have arisen among liberals and Democrats. Peraica would have been vilified with the usual refrain of "balancing the budget on the backs of the poor." Yet they were mum on Stroger.

Ironically, Stroger's fiercest critic was Peraica, who was incensed that while 712 high-paid management jobs were cut, 827 were added, for a net increase of 115, at a cost of $7.6 million. Spokesmen for county Sheriff Tom Dart and State's Attorney Dick Devine bemoaned the fact that the budget cut "front-line jobs" while padding high-paid jobs. "The bloat is still there," Peraica said. Republican county Commissioners Gorman, Pete Silvestri and Gregg Goslin backed the Stroger budget, as did Quigley.

But what definitely was not cut were friends and family -- derisively called the "Todd Squad." Stroger's sister got the $98,000-a-year job as chief of administrative services, and his cousin got the $143,000-a-year post of chief financial officer. Two brothers-in-law and a sister-in-law got cushy jobs, as did the wife of his best friend ($116,000 as purchasing agent), his father's doctor ($310,000 as hospital chief), a friend ($142,000 as human resources director) and another buddy ($150,000 as "liaison to the 8th Ward"). The son of a former state representative who served with Stroger in Springfield was named the $103,000 assistant comptroller, and the president's "spokesman," who rarely uttered a word about anything while getting $110,000 under John Stroger's administration, was demoted to a $95,000-a-year "liaison to churches" post. That is not "reform."

In the meantime, the investigation by the U.S. Attorney's Office continues. Last September all county personnel records were seized as part of a probe into doctored hiring tests and favoritism. The county's patronage chief, 8th Warder Gerald Nichols, was suspended and later fired. There surely will be some federal indictments before 2010.

County Commissioner Bobbie Steele was the acting board president during 2006, and she publicly griped about "systemic issues that impede efficient operation" of county government. That meant too many employees getting too much money for doing too little work, and that hasn't changed under Stroger. There are fewer employees, but those in management get paid more.

Fund-raising is an accurate indication of support: In 2006 John Stroger spent $1,690,078 and had cash on hand of $259,267 in his account as of Dec. 31. Todd Stroger raised $1,962,523, spent $1,715,969, and had $52,910. As an incumbent, he can readily amass $1.5 million in contributions for the 2010 contest. Peraica raised $688,206, loaned himself $546,566, spent $1,194,556, and had $29,618.

Claypool raised $2,402,068, spent $2,754,000, and on Dec. 31 had cash on hand of $17,499. Quigley, who was unopposed, raised $139,212 and had $499,068. Suffredin, also unopposed in 2006, raised $8,740 and had $1,426. Gorman raised $70,635 and had $60,174. Suffredin is wealthy, as are Gorman and her family. Either could self-fund a race.

The bottom line: The proverbial 800-pound gorilla is Claypool. He garnered more than $2.5 million in donations, ran against a popular black incumbent who he ripped for being inept and corrupt, had his campaign suspended due to Stroger's stroke -- and still almost won. Claypool is in the best position to beat the "Toddler" in 2010.

Of course, there will be real or fabricated county budget crises in December of 2007, 2008 and 2009. To survive in 2010, Stroger must acquit himself well, which means no tax hikes or spending spurts and some modicum of restraint in friends-and-family hiring and promotions, and the feds' investigation into county corruption must come to naught.

Otherwise, Stroger will lose, and his defeat would jeopardize Daley's 2011 re-election prospects. Stroger has thus far proven that he's not the "amiable dunce" many thought, but the 2010 election will be a referendum on whether he can keep on proving it.