Grassroots Power: Tennesseans Fight for Social Justice

Lucille Thornburgh may be one of the busiest political activists in East Tennessee. A veteran of the labor movement, at age 72 she has been battling injustice and ignorance for half a century. "I've been called a Communist by people who don't know Communism from rheumatism," she quips. As a senior citizen, she joined the ranks of the National Council of Senior Citizens (NCSC) and often demonstrates in that group's marches and other functions to help publicize crucial issues affecting the elderly. But it is mainly through her leadership in the successes of two grassroots organizations of young, old, and middle-aged people working together that she has earned public recognition in her own region. The Tennessee Valley Energy Coalition (TVEC) has waged an effective campaign against utility rate hikes and has raised the banner of medical reform; Solutions to Issues of Concern to Knoxvillians (SICK), has organized effectively against health-care cuts and telephone rate hikes, has conducted a successful voter registration drive, and is now taking on the task of reforming state taxes. 

TVEC, the older and larger of the two organizations (see SE, vol. 11, no. 1), formed in 1979 to face a major threat from the Tennessee Valley Authority (TVA). A federal agency created during the Great Depression to help relieve the severe poverty in rural areas of the valley, TVA has set and controlled utility rates in the region for half a century. But in the 1970s, after undertaking construction of a number of nuclear plants in the area, TVA began using rate hikes to finance uncompleted projects. When the scheme was discovered, many cried "foul" — and some of the loudest objectors were rate-paying older adults living on fixed or limited incomes, who were especially hard hit by the rate hikes. Lucille Thornburgh summed up the dilemma of many of those on fixed incomes: "Either you heat or you eat." 

With the help of the local chapter of the National Council of Senior Citizens and a few seasoned activists — including Lucille Thornburgh, Charles Wilson, Comer Robinson, and Stewart Butten — TVEC formed to channel this rage toward effective results. The elderly formed a large contingent of what current TVEC director Joanne Thompson describes as "a motley group of people who arose to face the common issue at that time — the issue of utilities." 

TVEC's two-fisted approach — enlisting grassroots supporters to pack TVA public hearings with standing-room-only crowds, and recruiting sympathetic energy experts to advise TVA officials on feasible alternatives to rate hikes — proved effective. Since 1981, TVA-controlled utility rates have remained relatively stable in spite of frequent attempts by industry and government to place a greater cost burden on residential customers. This is due in large part to what Thompson describes as "increased public consciousness about the way TVA proposed rate increases." 

The coalition accomplished its primary goal. In fact, it provided rate hike alternatives so effectively that TVA officials themselves now respect TVEC's expertise and even use the group as a weathervane for consumer opinion. But the arrival of success and respectability brought a dangerous lull in the political fervor that had motivated TVEC veterans. In response, the TVEC board decided to diversify the group's pursuits to meet a variety of regional needs, from voter registration drives to pressure for medical care cost containment. 

Speaking of the Tennessee Valley Energy Coalition, 80-year-old Hazel Butten observes that "the name is not appropriate for all the projects we undertake." Butten, a retired bookkeeper, spoke in September 1984 at the National Health Action Day sponsored by the National Council of Senior Citizens. The audience punctuated her pleas for medical care cost containment by rattling pill bottles in unison. Although the humorous gesture provoked laughter at the serious meeting, it also graphically demonstrated seniors' frustration with the government and with the medical profession. That meeting, which gave several seniors a platform from which to relate personal stories of gross overcharging for medicine and health care, received broad press coverage. Hazel Butten recalls, "We made an impression." 

Like several other members of TVEC, Butten came to the organization through the NCSC. The close cooperation between the two organizations in the Tennessee Valley region is apparent both in the number of members they share and in their common goals. TVEC has taken medical cost containment as its latest campaign, focusing specifically on doctors' willingness to "accept assignment" — that is, accept as full payment what Medicare gives for their services. Medicare, as all older people know, does not provide full coverage for doctors' bills. It pays 80 percent of an assigned rate, the rate determined by Medicare estimates to be reasonable. No one requires, however, that doctors accept assignment — and the ability of older people to pay for needed medical treatment hinges in large part on the availability of doctors who agree to accept the assigned rates. For example, if the Medicare assignment for a service is $100, a doctor who accepts assignment will charge $100 for the service, receive $80 from Medicare, and bill the patient for the remaining $20. A doctor who refuses to accept assignment may charge $200 for the same service, receive $80 from Medicare (80 percent of the assigned rate), then bill the patient for the remaining $120. 

With NCSC, TVEC assembled, printed and distributed a free booklet with information on local doctors. This medical directory lists local doctors and "scores" them on the percentage of Medicare-assigned rates each one accepted last year. It has been enthusiastically — and gratefully — received by older people. To add to the book's effectiveness, TVEC is corresponding with doctors and other medical personnel, encouraging them to accept Medicare's assignment rates at least 20 to 30 percent of the time. If they agree, their new score will be listed in the revised edition of the directory. "The medical directory," says Joanne Thompson, "is a real strong negotiating tool — it gives them [seniors] leverage. Having that information is powerful for them." 

Local doctors greet the new directory unenthusiastically. Dr. Fred Killefer, president of the Knoxville Academy of Medicine, grudgingly accepts the initiative: "I have no objection with that kind of information being distributed to the public," he said. "But it shouldn't be portrayed as those doctors who don't accept Medicare assigned amounts are overcharging." Generally, doctors are staying quiet about the directory. "They're laying real low," according to Thompson, who suspects that doctors fear they may some day be forced to accept Medicare assignment. 

As TVEC and other groups across the nation have compiled local directories of physicians who accept Medicare assignment, the federal Department of Health and Human Services has recognized the value of this information and has made its Participating Physicians Program Directory available to Medicare beneficiaries. The directory lists the names, addresses, and telephone numbers of the physicians in each locality who have agreed to accept Medicare assignments for all patients and services through September 1985. Individuals may photocopy, at no charge, up to 49 pages of their area directory at their local Social Security office. Groups are able to receive free copies by calling or writing the Medicare carrier in their area. 

TVEC and NCSC members are using their lobbying experience to support national cost-containment legislation that would make Medicare assignment acceptance mandatory among doctors, institute national ratesetting commissions to monitor and approve ratesetting practices, and preserve Medicare funding. NCSC and TVEC recently proposed creation of a government committee to study and approve or deny hospital expansions, which — much like TVA's construction of nuclear plants at the expense of ratepayers — are often funded by raising hospital charges. Another proposal suggests setting up a prescription drug review panel, which would advise physicians about the expenses of the medicines they prescribe, monitor the quality of some medicines, such as generic drugs, and perhaps even review the quantity of medication a patient may be receiving from more than one doctor, thus preventing dangerous over-prescription. 

For Monnie Jordan, individual problem-solving is one of TVEC's most important functions. The coalition headquarters on Fifth Avenue in Knoxville — next door to the O'Connor Senior Citizens Center — has developed a reputation for helping solve problems for individuals or families. On a typical day workers there might supply a needy family with a fan in hot weather or help locate a hard-to-find prescription drug. Jordan, a retired embalmer, former typesetter for a regional black newspaper, and now at 71 a very active member of TVEC, is proud of her group. "There are just a few organizations that will help the old," she says. "TVEC is about the best organization to show sincere interest in elderly people. TVEC gets answers — heretofore, we've just been living for promises." Jordan is one of a growing number of seniors who, having spent their working lives struggling to meet the demands of career and family, are turning to political activism in retirement. "The more older people you get to participate in TVEC, why, the stronger it will become. Older people have a confidence in TVEC — you build your confidence through the actual works and deeds that you do," says Jordan. 

 

SICK (Solutions to Issues of Concern to Knoxvillians) is a different sort of organization. While TVEC concentrates on building coalitions throughout the state and much of its work is done by hired staffers, SICK concentrates on developing local leadership, and its members make all the decisions that govern the group and direct its campaigns. While TVEC hires several full-time staff, SICK has but one paid staff-person: Monroe Gilmour, 38, a veteran of the CARE field service in India and elsewhere, who signed on in October 1984. "I just couldn't resist the energy of the organization," he says. As SICK's staff assistant Gilmour holds no decisionmaking power; he remains quiet during group meetings while the older members do most of the talking. When the time comes, they do most of the acting as well. 

As part of last year's Project Vote, TVEC joined forces with SICK to register new voters in the inner city. But the Knox County law director, Dale Workman, a Republican who referred to SICK as a "front for the Democratic party," informed the activists that the government cheese distribution lines were off limits and warned that anyone who continued to register voters there would be arrested. After conferring with SICK's own legal counsel and the Tennessee attorney general, a few defiant registrars challenged the law director's edict. Among them was Sam Peake, a 75-year-old firebrand, once an electrician and union man and now vice chair of SICK and one of its most active members. He calls the registration drive "one of the best experiences of my lifetime. 

"The two unemployment offices were supposed to be off limits. The managers said they would jail us. The attorney general told us, 'Yeah, they can take you to jail, but they can't keep you any longer than a phone call to my office.'" That day three lawyers representing SICK and TVEC presented their case before a federal court in Greeneville, Tennessee — and won. The federal judge ruled the law director's order unconstitutional. By election day, SICK and TVEC had registered 30,000 new voters throughout the state. 

 

Peake and the other members of SICK are getting used to taking on Goliaths. With about 20 core members who form a steering committee, SICK often tackles controversial issues as an "umbrella" organization, drawing in legions of interested people who tend to be ordinary private citizens who are not attached to any other formal group and who may never have been involved in politics in their lives. When they choose to take a stand with SICK to achieve a particular goal, they become ad hoc members for the duration of that fight. Neither SICK's membership nor its financial resources approach those of TVEC, which is funded by foundation sources, a canvass of its 4,000 sustaining members, and bi-annual reggae dances cosponsored with Save Our Cumberland Mountains (SOCM). 

Sarah Scott, who currently chairs SICK, is a great-grandmother, retired from a career as a domestic and food service worker. She suspects that older people make the most dedicated political activists. "Most young people are working for hire," she notes. In her view, seniors are at an advantage because they have more time to spend on political and social movements. Scott, like many older activists, spends more time working now than she ever did as an employee. "I think I need to get rehired so I can rest," she jokes. Lucille Thornbuigh — on the boards of both SICK and TVEC — agrees. She says she's been "doing more work since I've been semi-retired" than she ever did on the paying jobs of her youth. Concerning SICK, she adds, "We're more of an activist group than others around here — mainly because we have old union organizers like me. We're doing it in what to me is now the American way. We don't do it by writing letters, being nice little boys and girls. We've got to demonstrate, and embarrass somebody before we can get anything done." (For more about Lucille Thornburgh, see p. 36). 

The core of SICK's leadership is composed of older people; Scott, vicechair Peake, secretary and poet laureate Edna Owens (who composes SICK's fight songs), and executive advisor Thornburgh are all well past 60. Scott believes that the wisdom of age contributes to activism. "You reach an age of maturity where you realize the need for helping yourself and others," she observes. Thornburgh agrees: "I don't believe there's such a thing as a completely stupid 65-year-old. If they were stupid, they'd never have made it to 65. You've got to learn to beat the system." 

Elderly members of the community benefit from SICK's successes, but so far the organization has never undertaken any specifically senior-oriented projects. In fact, when SICK was formed in October 1982 it was partly in response to the pathetic story of a young woman in labor who was turned away from a local hospital because she couldn't pay the admission fee. The University of Tennessee Hospital, which had been under contract with Knox County to provide medical care for the indigent, had dropped the service. Representatives from a number of local community organizations joined forces. These included Thornburgh from NCSC and Peake (then a member of an inner-city neighborhood group); they had the assistance of Bill Murrah, a young community education specialist with the Knoxville Legal Aid Society. 

Thornburgh recalls, "We starting building a coalition [Solutions to Indigent Care in Knoxville]. We went to the county executive, Dwight Kessell, to talk about getting the county indigent health contract renewed. The hospital didn't want it — they thought indigent care should be spread evenly among all the hospitals in the area. Then we were talking to the hospital administrators. And we got a friendly press, bringing it to the public's attention. We were the only group doing anything about it. It was after the indigent care campaign that we changed our name to Solutions to Issues of Concern to Knoxvillians. And that's exactly what we are." 

After a six-month campaign, the county indigent care program was reinstated. Despite opposition from county, state and medical authorities, five of six local hospitals also opened their doors to the needy. The chair of the county's finance committee spoke admiringly of the upstart coalition and admitted to SICK representatives, "You are better organized than the county commission is." 

The members of SICK didn't have to wait long for more problems that required their attention. When Knoxville mayor Randy Tyree decided to trim the municipal budget by closing six inner-city firehalls, SICK organized the opposition. Says Thornburgh, "It was really kind of a frightening thing to old people living out in their little houses. We thought it was an issue that would concern a lot of people, and it did." SICK organized citizens who lived near the threatened firehalls and impressed public officials in open hearings with the numbers of people who would be affected by the cutbacks. Also impressive was the SICK-organized research committee, whose work proved that facts can be strong weapons. 

When the Knoxville city council voted to keep the firehalls open, Mayor Tyree inadvertently complimented the activists. "The only reason you voted the way you did," he scolded the council members, "was because of the pressure of these citizens here" — pointing at the SICK representatives in attendance. 

The people of SICK began to feel they could conquer any giant. When AT&T broke up in 1983, the valley's phone company, South Central Bell, planned a phone rate increase for residential customers in Tennessee that would have amounted to $14.50 per household. The hike would have hit many elderly people especially hard, since for them a telephone is more than a luxury. Lucille Thornburgh comments that, for many older people who live alone, "their phone line is their life line. It's their only means of communication with the outside world. When they started talking about doubling rates, and tripling rates, it was frightening." 

In taking on the phone rate hike, SICK mounted its most impressive campaign yet. The Tennessee Public Service Commission (PSC), which is charged with the responsibility of appraising telephone rate changes, was ready to grant the raise. One poorly publicized PSC meeting in Knoxville drew only a handful of citizens. But when SICK entered the fray, both the PSC and the public took notice. The PSC and Bell held another Knoxville hearing, this one attended by about 225 citizens — most of them associated with SICK. The PSC chair was obviously impressed, saying that the crowd was the largest of any such meeting he had attended. 

SICK then moved its assault to the statewide level. A bus, funded by many small contributions, carried 65 SICK volunteers to Nashville for a hearing where several SICK members testified about the importance of inexpensive telephone service, especially to older people and the handicapped. Over the heads of the audience, SICK leaders unfurled a 100-yard-long petition bearing the names of 7,000 citizens who thought the rate hike unfair. SICK had displayed the same petition a few days earlier in the streets of downtown Knoxville, in front of Bell headquarters. (While showing off their behemoth of a petition in downtown Knoxville, Thornburgh recalls, "nobody bothered us. We dropped the petition at one point and a policeman helped us pick it up. Even the policemen were interested in that issue.") 

The PSC did grant Bell an increase, but only a fraction of what Bell had requested. Residential rates went up by only $.54 per customer, not the $14.50 proposed. Many, including the PSC chair, credited SICK with limiting the rate hike. Bell's district manager complained, "There have been some bad moments — 300 people from the SICK organization always pointing fingers at you." 

SICK members ascribe their enormous success to the leadership and leadership training within the organization. Before every public campaign, members rehearse confrontations with their prospective adversaries, with group leaders playing anti-SICK devil's advocates. "You need to know all the trap questions that might be asked," asserts Peake. "We rehearse every angle." Research, planning, and education combine to make each SICK activist an expert. 

SICK chair Sarah Scott attributes the enthusiasm of SICK members to the group's system of rotating leadership. The chair and other officers change yearly, with other members delegated to research, advocate, and organize action on particular issues. Still others are in charge of everything from scavenging needed materials to painting signs to writing fight songs. "We're constantly learning," says Scott. "Every time we meet, we learn something new." 

Sam Peake is heading SICK's latest project, which is even more ambitious than the telephone campaign. Tax reform is always a formidable undertaking, and in fiscally conservative Tennessee a progressive income tax might seem an unlikely dream. But Peake and his cohorts have proposed a tax reform plan that they think will work, and they are determined to see it enacted. 

In the SICK Fair Tax Plan, sales tax would be cut to 3 percent and would be removed from food altogether. Lucille Thomburgh understands what the tax on food means to a hungry family or individual: "Seven dollars out of every hundred go to taxes. Seven dollars would buy a chunk of meat and a little can of black-eyed peas. I think that's very important. You can live without luxuries. There's no way to live without food." Peake, SICK's tax expert, agrees: "Sales tax is the most regressive type of tax there is, and Tennessee has one of the worst." 

SICK's proposed simple graduated state income tax consists of a 2 percent tax on incomes up to $20,000 per year, a 4 percent tax on incomes from $20,000 to $40,000, and a 6 percent tax on incomes above $40,000. SICK arrived at this tax schedule after soliciting advice at a Washington, DC, workshop and conferring with tax experts at the University of Tennessee. 

SICK members know that winning a state income tax in Tennessee will be an uphill battle. But Lucille Thornburgh, the member with the most experience in political and social activism, has high hopes for the Fair Tax Plan. "I think we will get the support we need from the people if we really get it across to them."