By John Eckberg
The Cincinnati Enquirer

A Deloitte survey of the top 100 privately held companies in the region sheds plenty of light on significant challenges facing local businesses.

The biggest worries by priority are:

• The economy.

• Operational efficiencies.

• Satisfying customers.

• Controlling health-care costs.

Although executives cited health care as their No. 4 challenge, they made health-care reform the top priority for government action.

Executives also want government to deal with terrorism, tax reform, Social Security reform and business fraud.

Entering new markets or creating new products was the growth strategy for about half the companies on the list.

What Peter W. Chronis, president at Reece-Campbell Inc., a general contracting and construction management company, wants from his local government is pretty simple:

"Provide an environment that is suitable for business," he said.

"I want the infrastructure, streets, curb landscape and public spaces that are clean and in good repair. That's No. 1 for an environment that is good for business."

He said, too, that tax incentives might be necessary for the city to keep and attract businesses "while the city attacks in the long run, goals, objectives and improvements necessary to keep businesses here without incentives."

While many companies have seen rising health-care costs, Larry Rayburn, president and chief executive of Richard Goettle Inc., said his firm saw health-care expenses shrink this year compared with last year.

"We changed providers and got the same coverage but with a 15 percent decline," Goettle said.

He said many of the problems with rising health-care costs stem from court judgments against doctors and pharmaceutical companies.

"We have to do something about those court cases. That's a good start," he said.

Rayburn said he thought that most workers have already achieved efficiencies on the job.

"People are working harder than they have in years," he said.

E-mail jeckberg@enquirer.com.