With the Senate Finance Committee approving a health-care reform bill, all the notions and what-ifs will start to crystallize into actual do’s and don’t’s.

We all have a keen interest in having the best health care we can afford. It’s appalling that the United States can spend more than $2.2 trillion a year on health care but not have the world’s best system.

But as difficult as it has been for the House and Senate to get to this point, now the truly difficult negotiating begins.

The arm-twisting may be going on in Washington, D.C., but you better believe that the pain that must come with any changes will be keenly felt in our region.

After all, our economic development gurus proudly tout Philadelphia’s life-science cluster that has grown phenomenally and provided lots of high-paying jobs.

A report issued by the Milken Institute in May said that one in six jobs and 15 percent of all economic activity in the Greater Philadelphia area could be attributed to life sciences. The Milken economists calculated that health care is responsible for 380,000 jobs here.

When something has grown so steadily for so long into something so huge, it’s time to worry about when the music is going to stop, even if the band in Washington is still trying to decide which tune to play.

All the players that could be affected by health reform have put on their brave faces and offered encouragement and campaign contributions. They have to.

What I can’t figure out yet is which part of the sector will lose more in the name of reform.

Will it be the health insurance industry? The Big Three locally - Independence Blue Cross, Aetna and Cigna - have a total of more than 12,000 employees here.

Or Big Pharma? Collectively, Merck & Co., Johnson & Johnson, Wyeth, GlaxoSmithKline and AstraZeneca had more than 31,000 employees locally as of last summer.

Maybe it will be the gravity-defying, ever-expanding hospital sector. Five of the region’s ten biggest employers are hospital systems.

But I am sure of this: For a region so dependent on health care, nothing matters more this fall than how much status quo Washington decides must go.
 

In mid-August, Inc. magazine reported that DSG Inc., of Malvern, was the fastest-growing privately held firm in the Philadelphia area.

I wrote a column about the annual Inc. 500 list, focusing on local firms such as software developer DSG.

Two months later, it turns out that DSG was not on top locally.

How could that be? I relied on data gathered and calculated by the publication for its list. The magazine requires verification for the information submitted by the companies, such as annual revenue.

The 2009 list ranks companies by the change in revenue from 2005 to 2008. DSG president and CEO Tony Varano on Monday said Inc. magazine told him it had made a data-entry error for the company’s 2005 revenue.

The project manager in charge of the Inc. 500 was out of the office. An Inc. staffer would say only that changes made to the list are rare and must be verified.

Last August, Inc. listed DSG’s 2005 revenue as $1.7 million, when it was actually $11.7 million. Its 2008 revenue was $32.1 million.

So while Inc. initially listed DSG as having three-year revenue growth of about 1,800 percent, it has now corrected it to 175 percent. Still fast growth, but the revision places DSG at No. 1,817 on the Inc. 500 list rather than the more lofty No. 82.

According to Inc. magazine, that makes Clear Align L.L.C., of Eagleville, with 2005-08 revenue growth of 1,305 percent, the fastest-grower locally.

Begun by president and CEO Angelique X. Irvin in 2003, the firm makes sensors that incorporate night-vision and other imaging technologies for military and security use.

What’s amazing is that Irvin never planned to start a business, much less build one that’s experiencing such rapid growth. (It’s No. 135 on the Inc. 500.) She’d begun work on a project for a defense contractor, then another, before she realized what she had was a company.

Totally bootstrapped, Clear Align now employs 53 people - many with Ph.D.s - at its Trooper Road operations. Its 2008 revenues were $5.5 million.

“You have to recognize it’s a combination of talent and luck,” she said.

But it’s also true that talented people can make their own luck.

From the time I was a kid, I’ve been a saver.

Passbook savings accounts, certificates of deposit, money market mutual funds - I’ve used them all over the years for different purposes. Now, cash accounts are where I keep the three months worth of expenses that the experts always say is the minimum we need on hand.

But until a couple of weeks ago, I hadn’t bought a CD since the mid-’90s. I’d let the last one mature shortly before buying my first house. Money market funds and my savings account with an Internet bank just seemed more flexible and convenient. No penalties for early withdrawal.

So why did I do it?

Well, I’m saving for a hefty planned expense coming next spring.

Remember the good old days of saving up for that new bike you wanted instead of reaching for a credit card? Nostalgia is nice, but I find I save better when I trick myself into doing it. For years, I had $25 a month automatically deposited from my checking into a savings account. (I didn’t miss such a small amount of money, so I upped it to $50 a couple of years ago.)

Sock away $50 a month over 10 years and you’ll have more than $6,000. Some would say that’s almost real money.

How am I tricking myself into saving for this expense? I “depleted” my emergency cash pile by a few thousand by putting it into a 6-month CD.

The money’s not gone. It’s not untouchable. But because I can only tap it by paying a penalty of 3 months’ interest, it feels like I have less of an emergency cash cushion.

So I adjusted the automatic deposit amount in my savings account with the goal of replacing the principal amount in the next six months. I’m hoping it won’t squeeze the household budget too much. So far, so good.

Reality check time: My CD carries an annual percentage yield of 1.55 percent. That’s better than the average 1.354 percent APY for 6-month CDs, according to Bankrate.com. And it’s better than the 1.3 percent yield on my savings account.

But I won’t yell “jackpot” anytime soon.

Still look at it this way: Every little bit helps.

Plus, six months from now, if I wind up not having to pay that expense, I will have just strengthened my household safety net.

Or I might buy a new bike.

If you work for a business or other organization in the region’s private sector, there’s a good chance that you’d like something to change.

Maybe it involves how you get to work. Maybe it’s about how much you pay in taxes or the type of taxes you pay.

Well, now’s your chance to tell the Greater Philadelphia Chamber of Commerce about the issues you think it should be fighting for.

New president Rob Wonderling this week unveiled the chamber’s new advocacy campaign, called Relay, by starting with a survey of more than 25,000 people in Center City’s office towers, suburban office parks and home offices everywhere.

Sent by an e-mail blast, the survey is also available on the chamber’s Web site here.

For the next month, Wonderling and his staff will be in listen-mode. The intent is to cast a wide net to catch the opinions of not only the 5,000 members of the Greater Philadelphia chamber, but also non-members, the self-employed, even those in the entrepreneurial tidal pools.

But data-gathering is almost the easy part. The challenge will be to distill what they learn into an action plan. Wonderling promises a more sustained, grassroots approach to how the chamber advocates its positions on various issues.

I’d have to say the chamber has been strikingly unmemorable in taking a stand on issues, such as tax policy, that entrepreneurs wind up calling newspaper reporters about.

With the tattered shape of all government budgets, no one expects tax cuts now. (But maybe some targeted job-creation tax credits?)

In his remarks at the chamber’s annual meeting on Wednesday, Comcast Corp. executive vice president David L. Cohen noted that he was proud of the “public advocacy maturity” of the business community for supporting Mayor Nutter’s measures to close the city’s budget hole by halting cuts in the wage and business privilege taxes.

What if the survey respondents reject that maturity, as Cohen, who is the chamber’s chair, called it? What if there’s as much anger over the budget woes in the C-level suites as in the rank-and-file cubicles?

You have one month to let the chamber’s leaders know how they should respond on all sorts of issues.

So tell them.

Two things are clear about Pennsylvania’s broken state budget process:

Every proposed compromise has annoyed a new set of constituencies. And, the many rallies held to blast legislators over the lack of budget haven’t produced much pressure.

On this, the 100th budget-less day for fiscal 2009-10, an ad hoc organization representing more than 80 nonprofits intends to try again, holding a rally at the Municipal Services Building near City Hall at noon. I doubt the message sent by these advocates for the elderly, children and the sick will launch lawmakers into action.

Pennsylvanians profess to be embarrassed that their state is the only one in the nation still without a budget. But embarrassment alone hasn’t been enough to convince lawmakers to pass one.

The fact is the absence of a state budget has meant little to the daily lives of many Pennsylvania residents. Quite frankly, I’ve barely noticed the difference between a Pennsylvania with a budget and one without.

On a mid-July morning, I renewed my driver’s license with unexpected ease. The photo license center had me in and out in five minutes.

In late September, I drove to Pittsburgh to attend the Group of 20 Summit, taking the Pennsylvania Turnpike. Save for several miles of “shovel-ready infrastructure” work, it was a painless, if long, trip.

This being anachronistic Pennsylvania, I had to go to a state store to buy a bottle of wine recently. The shelves were full. No inventory shortages for the Wine & Spirits shop.

Kids are in school. State police continue to patrol the highways. You can still visit most state parks. Gamblers keep dropping their cash into state-regulated slots parlors.

In short, there’s been no disruption in here akin to California’s issuing IOU’s.

Gosh, if the state runs so well without a budget, who really needs one?

Well, we all do. I have a household budget that I’ve been trimming over the last year. Businesses cut their budgets heading into 2009. Nonprofit organizations have reacted to a decline in donations.

We’ve all adjusted to the financial reality created by a brutal recession. Either Pennsylvania lawmakers don’t see that same reality or they refuse to adjust to it.

Can NutriSystem Inc. bulk up at Wal-Mart?

The diet-plan purveyor yesterday said it had snagged a deal to sell a two-week, $148 "starter" version of its weight-loss program at 3,200 Wal-Mart stores.

Shares in the Horsham company jumped as much as 22 percent at one point, and volume surged by a factor of 20 over average.

NutriSystem, whose second-quarter profit fell 60 percent on a revenue decline of 32 percent from last year, said it was hitting Wal-Mart shelves "at the brink of the holiday rush and leading into the height of the 2010 New Year's resolution season."

The company has had a deal since January to sell NutriSystem in Costco stores. "We're still there," NutriSystem spokeswoman Susan McGowan said of Costco yesterday tues, but she would not say how Costco sales were going.

Analysts Mitchell B. Pinheiro and Brian Holland, at Janney Montgomery Scott in Philadelphia, put out a note to investors that the Wal-Mart deal was "on a much greater scale" than Costco.

But the duo concluded, "We are not looking for any meaningful lift from Wal-Mart" in the fourth quarter.

Online layaway

Many stores ditched layaway programs in the years of easy credit, but not Kmart. Now, having detected new interest in the old-fashioned payment method, the retailer is taking layaway to the Internet.

Kmart's owner, Sears Holdings Corp.announced yesterday that Kmart and Sears customers could go online to put 10 percent down on a purchase and make biweekly payments on an eight-week layaway plan.

Customers may use a debit card, or store gift card to make the payments. They can also use a credit card, though it's not clearit was unclear whom that might benefit.

Procrastination

People who filed for six-month extensions on their 2008 federal income tax returns need to take note.

Your new filing deadline of Oct. 15 is fast approaching. The IRS says 264,000 Pennsylvanians and 295,000 New Jersey residents filed for extensions.

Lots of analysts have been warning that the U.S. is just getting warmed up when it comes to bank failures.

Sure, the biggest basket cases were probably addressed, rescued or bailed out (take your pick of characterizations) last fall with the $700 billion Troubled Asset Relief Program.

But the Federal Deposit Insurance Corp.’s running total of failed banks for 2009 is up to 98. The FDIC also says 416 institutions were on its “problem list” as of June 30. (No, the FDIC doesn’t name names.)

Few expect the level of failures to reach what was experienced during the savings and loan crisis of the ’80s and ’90s. That doesn’t mean everything’s fine either.

Credit-rating agency A.M. Best Co. ran its own proprietary model on the 7,476 commercial banks regulated by the FDIC and found that 505 of them could be considered “troubled.” That’s 6.8 percent of all U.S. banks.

What makes for a troubled bank in A.M. Best’s view? Besides having weak capital ratios, it tends to be more exposed to commercial real estate loans compared with industry norms.

Of those 505 troubled banks, 272 are at high risk of failure, according to A.M. Best analysts Tam V. Nguyen and Kevin McFadden.

Oldwick, N.J.-based A.M. Best will not say who’s at risk, but it does say where: Georgia, California, Florida, Illinois and Arizona.

Georgia could have 73 troubled banks on its mind. A.M. Best says 20 are at high risk of failing.

Here, Watchdog

In a speech largely about encouraging innovation to spur cancer-care breakthroughs, AstraZeneca P.L.C. CEO David Brennan renewed a call for more funding for the Food and Drug Administration.

“An understaffed and underfunded FDA is an agency in crisis,” Brennan said Monday at the Medical Innovation Summit in Cleveland.

It may seem odd for the regulated to call for “a watchdog with a full set of teeth,” as Brennan said. But the reputations of the drug industry and FDA have been shredded in recent years.

Sure, everyone want to help patients. But the drug industry, which has done well by doing good (and not so good), wants to be seen as open to change even as it braces for reform.

Big business and big labor are bringing a "Keep It Made in America" town hall event to Lincoln Financial Field today at 6 p.m.

The Alliance for American Manufacturing says that Philadelphia is the first stop for this fall tour, but the group has held similar events around the country in recent months.

Organizers say the free event is open to the general public. And they look to be pushing the right buttons by promising to have current Philadelphia Eagles middle linebacker Jeremiah Trotter and that "Invincible" Eagle Vince Papale there to sign autographs.

The group behind this public-policy alliance is largely the steel industry, including the United Steelworkers union, U.S. Steel Corp. and Allegheny Technologies. The organization has taken aim at the imbalance in China-U.S. trade and has been pushing the Obama administration to take a harder line on enforcing current trade laws.

One local group participating in a panel discussion on the state of manufacturing locally is Joe Houldin, chief executive officer of the Delaware Valley Industrial Resource Center.

Many public companies took advantage of September’s stock market rally to raise more capital.

According to Bloomberg News, there were 11 initial public offerings that raised $4.36 billion and 97 secondary offerings that raked in $19.21 billion. Compare that with only two IPOs and 37 secondary offerings in September 2008.

In the Philadelphia region, four companies completed secondary equity offerings, totaling more than $480 million, last month.

Incyte Corp., a Wilmington drug developer, raised $132 million from an offering of 20.7 million shares at $6.75 per share. (Incyte also raised $387.3 million in a convertible note offering.)

Auxilium Pharmaceuticals Inc., a Malvern biopharmaceutical company, raised $115.7 million from an offering of 3.45 million shares at $34.50 per share.

Penn Virginia Resource GP Corp., a Radnor company involved in coal and other natural resources, raised $102.7 million from an offering of 8.7 million common units at $12.30 per unit.

And National Penn Bancshares Inc., of Boyertown, boosted its capital by $133.1 million by issuing 26.7 million shares at $5.25 per share.

National Penn wasn’t the only bank with local ties to tap the public markets while the money was hot. First Niagara Financial Group Inc., which is acquiring Harleysville National Corp., raised $441.5 million by issuing 38.3 million shares at $12 per share. That was First Niagara third offering in a year.

Harrisburg-based Metro Bancorp Inc., which has agreed to acquire Philadelphia-based Republic First Bancorp Inc., netted $70.7 million by issuing 6.25 million shares at $12 per share.

Finally, US Airways Group Inc., the biggest airline at Philadelphia International Airport, received $137.3 million after issuing 29 million shares at $4.75 per share.

First Address

Rob Wonderling, who was named president and CEO of the Greater Philadelphia Chamber of Commerce in August, will outline his agenda at the group’s annual meeting Wednesday morning.

Expect the former Republican state senator who represented parts of Philadelphia’s northern suburbs to emphasize encouraging entrepreneurship and strengthening the region’s tech communities.

Also speaking at the Convention Center will be Comcast Corp. executive vice president David L. Cohen, who is chairman of the local chamber. He probably won’t be speaking about the odds of Comcast’s landing NBC Universal Inc.

And it might feel like a Sunday morning with ABC News’ George Stephanopoulos slated to give an address on the nation’s priorities.

New Wrinkle

There is no bigger day for a small drug company than when it goes before a Food and Drug Administration advisory panel to make its case for approval of its first product.

For the Exton company once known as Isolagen Inc., Friday is that day.

Plus, it steps into the regulatory spotlight with its experimental wrinkle treatment little more than a month after emerging from bankruptcy.

Now called Fibrocell Science Inc., the company is seeking approval of its Isolagen Therapy as a treatment for those skin folds that run from the sides of the nose to the corners of the mouth.