Month: December 2021

NEWPORT, Tenn.—Five years ago, a Cocke County man filed bankruptcy after a tree fell on him, he suffered injuries and was handed a medical bill for $350,000. Although significant enough on its own to stun anyone, a large portion of the sum came as a surprise fare, owed to an ambulatory helicopter ride to the hospital, costing $50,000 by itself.

However tragic, his story is hardly unique, and follows an American trend: nearly two thirds of all bankruptcies in the U.S. take place in response to medical expenses, adding up to about 530,000 medical bankruptcies each year.

The former Conagra worker, a man in his thirties who asked not to be named for personal reasons, said he was cutting down a large tree at the edge of his property, when it suddenly collapsed, knocking him unconscious and trapping him underneath in an instant.

In many cases a person may be coherent enough to decline an ambulance and even get themselves to a hospital. In severe cases like his, however, sometimes immediate air transport to the nearest trauma center is the only recourse. It becomes a choice of life or death, and it was not his choice to make.

“When I woke up, this arm was over here, like behind me, over there, and I was pinned,” he said. “The tree was on top of me. I could not move. I hollered for 30 minutes.”

He said after he was found by a neighbor, it took another 45 minutes for paramedics to arrive. They told him he would not have made it much longer.

“I was about to go into shock, and they cut the tree off of me,” he said. “They used my saw to cut the tree off of me. The tree was as big as a tractor tire. It was humongous. They didn’t know how I survived. Somebody was watching out for me. I like to think, Mom.”

He was transported from the scene by helicopter, to Johnson City, where he stayed and received treatment for severe injuries.

Following that traumatic event, Conagra has since closed their plant. He said he lost his insurance, and now has to pay several hundreds of dollars out of pocket, into the thousands, for routine hospital visits and follow-ups. Bankruptcy, he said, clears in seven years, but it still hurt his credit and does nothing to alleviate the high costs of presently needed treatments or preventive care.

For a person faced with life-threatening injury, the hospital stay – even with insurance – can be expensive. However, many do not consider the extravagant cost of air ambulatory services, which can come in the form of its own separate bill – and a surprise – especially to those who have never been transported to a trauma center before.

In the last five years, air ambulance costs have increased by more than 30%, according to data published in a September report by FAIR Health, a nonprofit organization that analyzes healthcare costs, market rates and insurance information. The study addresses both fixed-wing and rotary-wing air ambulance transport costs.

Their four-year study showed that the top diagnoses associated with helicopter ambulance rides in that period include cerebrovascular issues and diseases, heart attack, body injury, head injury and stroke.

The study showed that in a three-year period, the charges associated with helicopter ambulance transports for those events – like those used to service eastern Tennessee – increased by more than 22.2% to an average of more than $30,000 per flight.

Rates have increased so fast that the Biden Administration proposed new rules on September 10 requiring greater transparency in air ambulance costs, and how agents and brokers are compensated.

The proposal, announced through the U.S. Department of Health & Human Services, states that new rules would allow HHS to collect data to analyze market trends to address exorbitant air ambulance expenses.

“No one should avoid seeking health care for fear of receiving a surprise medical bill,” the statement read, quoting Chiquita Brooks-LaSure, Administrator of the Centers for Medicare and Medicaid Services. “The new consumer protections released today are critical to shielding consumers from the devastating financial impacts that may occur as a result of an unlawful surprise bill, and CMS is committed to vigorous enforcement of these protections.”

Because insurance may not cover the total cost of emergency treatment, and out-of-pocket costs like deductibles or copay still apply, the providers of these services usually offer annual subscription services, a product resembling insurance, against the high cost of their ambulatory services.

Depending on which hospital a patient is delivered to, the air ambulance helicopters are branded differently, but in eastern Tennessee, both are covered by a single provider, and they offer annual membership plans that cover the full expense of the flight.

In Cocke County and the surrounding areas, that service is called AirMedCare Network, and they charge $85 per year per household, or $65 for seniors age 60 and above, and their households. The program covers the full cost of the flight, regardless of insurance status.

Med-Trans, a participating provider in the program, covers flights from Newport Medical Center and areas around Cocke County either to Knoxville or Johnson City. If a patient needs to go to the trauma center in Knoxville, UT LIFESTAR brings them by helicopter. Someone destined for the trauma center in Johnson City would be transported by HEART, which replaced Wings Air Rescue last year.

A dispatcher for First Call Ambulance Service confirmed that all their requests for an air ambulance go through AirMedCare.

“We do have more than one helicopter service,” Chad, the dispatcher said, “but they’re all owned by the same people.”

Air transport is often covered through insurance, with a copay. Humana is a for-profit American health insurance company based in Louisville, Kentucky. Because Humana is contracted with the federal government to provide and administer Medicare plans under the Medicare program, many people in Cocke County, and across the U.S., access their Medicare benefits through Humana.

Based on accounts in their system, a Humana representative working in El Paso, Texas said Humana members are charged a $250 copay for a helicopter flight, same as a ground ambulance, with an additional $250 copay required separately for any medical services performed onboard the aircraft, or at the hospital.

“Overall, they’re not just paying that 250,” the representative said. “It doesn’t include treatment. Whatever they’re doing to them inside the ambulance, or whatever they do to them after the fact that they got dropped off, that will probably be its own separate bill.”

Christie, an account sales representative with AirMedCare Network, said their membership covers both the costs of the flight, and treatment received on the aircraft, with no copay.

“If you’re ever airlifted by us, we will bill your insurance or whoever is responsible to pay for your medical care,” she said. “We’ll take what they pay as payment in full, then the membership covers the rest.”

Christie’s advice that the flight would be covered, as well as treatment performed onboard, could not be independently verified.

Global Medical Response is the holding company over the program, and Shelly Schneider, Director of Public Relations, said she is not sure if HEART is considered a “traditional model,” meaning the helicopter, pilot and mechanic are provided, but the medical crew would come from the hospital. This would generate two separate bills.

“Or if it’s a community-based model—so Air Evac Lifeteam is also in Tennessee, and those are community-based models,” Schneider said. “So Air Evac has the pilot, the mechanic and the med crew – the nurse and the paramedic – and so that might be billed differently.”

Schneider said she would find out how HEART and UT LIFESTAR are billed, but did not follow up by the time of publication.

Federal data being collected on air ambulance services could shed light on the other unknown or lesser known costs associated with air ambulance services in the future, according to the September HHS report.

The department stated that information would be used in a comprehensive, publicly-available HHS and Department of Transportation report to increase transparency and help inform future policy development aimed at addressing these costs.

This story appeared in The Newport Plain Talk.

NEWPORT—Citizens gathered at Newport City Park on Sunday to meet a Memphis city councilman who is seeking the Democratic nomination for Tennessee governor.

Speaking to an audience of about seven people, 34-year-old Memphis City Councilman JB Smiley, Jr. said he wants to reduce crime, see more people vaccinated, and increase mental health funding to distressed regions of the state—money which he said can be shifted to suit the purpose.

Smiley said during his career as a lawyer and councilman, every piece of legislation he has proposed in Memphis has received support from leaders of both parties.

“I’m a Democrat, but before anything else I’m a lawyer and that means I’m in rooms with a lot of different people who may or may not agree with me,” he said, “but once you’re able to find common ground and focus on the issues that improve the lives of folks, you can move the needle.”

He said despite partisanship, his progressive legislation often had the conservative-leaning chairman’s name on them, because finding common ground and shared goals have allowed them to cooperate, regardless of party affiliation.

“People assume Memphis is a progressive place,” he said. “It is not. The chairperson of our city council was the fundraising chair for Donald Trump.”

Although his status as fundraising chair for Trump could not be verified at the time of publication, Memphis City Council Chairman Frank Colvett, Jr. was elected to the city council in November 2015, became the 2021 Chairman of the Memphis City Council and – according to his campaign website – Colvett served as Treasurer of the Tennessee Republican Party. Colvett is now listed as nonpartisan, or unaffiliated, but retains the support of the Tennessee Republican Party.

Last month Gov. Bill Lee signed legislation outlawing vaccine mandates for schools and government entities. Smiley departs from that approach on his own gubernatorial platform, saying he does not want to “preempt” people, a legal term that he says when applied to Tennessee, suggests vaccine mandates should be handled at the local level and not at the state level.

“I don’t necessarily agree with preempting folks,” he said. “You encourage people. Preemption is when the state comes in and says we’re going to supersede whatever the local municipalities put in place for their constituents. Local control is important. They understand their issues better than anyone who resides in a different county. You come to Shelby County, and I’m going to understand Shelby County better than someone who sits in Nashville. You come to Newport, same thing.”

He said there are, however, cases when the state should step in. He said no amount of additional police, for example, will address the root causes of crime, whereas education and early opportunities are proven to play a role in reduction.

“What the state doesn’t do – when we talk about homelessness, when you talk about folks addicted to drugs, the state has not provided funding for mental health institutions,” he said. “If we provide funding for mental health institutions, we’re going to get a lot of those folks off the street, get a lot of those folks off the drugs, and if we’re able to do that, we’re reducing crime.”

According to data released by the FBI, the crime rate of Newport – although decreasing yearly – is 246% higher than the national average, where residents are faced with a 1 in 13 chance of becoming a victim of crime. Newport is safer than just 2% of American cities. The solution, Smiley said, is to care about people through compassionate policy and legislative action.

“The goal of government is to provide for the general welfare of its people,” he said. “We’re the third most violent state in the country, and we aren’t taking any measures to address it. We’re actually doing the opposite. We’re putting more guns on the street. We’re not providing funding to help folks with drug issues. I’m just saying we’re hands-off. Taking it one step further, we’re moving funding from early childhood education. Well guess what happens when you remove funding from early childhood education? You’re perpetuating the school-to-prison pipeline. Why? Because we’re funding private prisons.”

Smiley said Tennessee’s hands-off approach to crime, social programs, and funding to distressed areas is a reflection of missing social attitudes at the state level, a skill set he claims to possess and wants to apply to state legislation.

“It’s about how you talk to people,” he said. “I’m not asking about any political philosophies. Let’s sit down and talk: ‘how’s your wife?’ You know, ‘What’s going on in your community? What’s your pain points? Oh, I understand, I have the same issues here.’ Once you get to know someone as a person, you figure out how to work together collaboratively, and nine times out of 10, we get them to move the needle, and the goal is to move the needle for everybody.”

Marjorie Ramsey, Chair of the Cocke County Democratic Party, said of the voters in attendance, some people had come in from Sevier County to hear Smiley speak. She said The Newport Plain Talk was the only press in attendance for the event.

“I told them they might sell some better newspapers if they quit putting them Republicans on the front page, and editor’s page,” she said. “There’s a lot of Democrats in Cocke County that’s quit taking his newspaper, and I’d tell him that right now.”

A woman from Ramsey’s church, who asked not to be named, said it was the first time she’d seen the candidate, and had never heard of him until she was asked to attend.

Smiley joined a Democratic primary race in September that now includes Dr. Jason Martin, a Nashville ICU physician and critic of the state government’s response to the COVID-19 pandemic, and Carnita Atwater, a gentrification opponent and owner of the Kukutana African-American History and Culture Museum of Memphis.

An assistant for Smiley said he would campaign next in Greeneville, Chattanooga and Nashville.

This story appeared in The Newport Plain Talk.

You might have seen their ad in The Smoky Mountain Trader, but if you have never stopped by the I-81 Flea Market on a weekend then you are not only missing the best prices available on goods in Hamblen County, you may have overlooked a cultural mainstay of eastern Tennessee.

The I-81 Flea Market – open from the first Saturday in March, through the last weekend of November – is half a mile north along 25 E, from Exit 8 off I-81. Vendors can expect to rent a table for seven dollars a day, and buyers can expect to find all manner of goods, including antiques, food, tools, home appliances, decorative goods, clothing, jewelry, homemade blankets and dresses, and everything in between.

Mary Knight started the I-81 Flea Market in 1981 with her late husband Don L. Knight and their business partner, Tommy Horner. For 40 years, hundreds of people have walked the grounds each weekend. On its busiest days, the flea market could see upwards of 1,000 people.

“I enjoy people, and some of the nicest people in the world are right here,” Knight said. “Really and truly they are. That’s what I like about this market. Everybody’s kindly on the same ball field, and they look out for each other.”

A central theme of her management style, Knight said she does not allow anything to interfere with the enjoyment of the youngest and oldest age groups who visit the flea market. She categorizes herself somewhere in the middle.

“I figure the ones in between, like myself, we can take care of it,” she said. “I figure we can handle whatever comes up, but you got to take care of those two groups.”

She describes the flea market as a family-oriented place. On a sunny weekend, there are dozens of children from all backgrounds running around in the grass, playing together, and helping their families.

“Got a lot of kids here,” she said. “Got a lot of older people here, where this is their social life.”

On a cold, rainy Saturday morning in November, just before sunrise, one finds a group of men under the first covered shed, preparing for the sale, talking, laughing, making early trades, and carrying on with each other. On this particular morning, rain was making life difficult, but the die-hards were already out working that day, setting out goods on their reserved tables, and talking among themselves.

“Where are you going for breakfast?” a bearded man asked his friend, Roy. “Why don’t you ever eat your wife’s breakfast?” he joked, opening the meal she had cooked earlier that morning and sent for him and his son, but not Roy.

“Roy eats at Hardee’s,” someone said back. “He likes their country ham.”

“That salty country ham sure is good, but you’ve got to watch your blood pressure,” the bearded man advised, pointing at Roy for emphasis.

His name is T.J. Noah, and he has been in the trade since 1977. Knight says T.J. and his son Thomas have been selling merchandise every weekend at the flea market for the past several years. They are often the earliest vendors to open on Saturdays, and even show up in the rain, on days like today, selling name brand foods, snacks, cookies and drinks. A pack of soft cookies that sells for $4 in stores, for example, T.J. offers at his table for just 50 cents. Chips can go for a quarter a piece. Even his bottled drinks are not expensive, but the stories are free.

In the late ‘70s T.J. said he first got into business running his own auctions.

“Remember I used to have that sign on my door?” T.J. asked of his nearby friends. “‘T.J.’s way or the highway?’ Remember I told that woman don’t let the door hit you on the ass?”

Everyone laughed who already knows the story.

He said even though he was the one holding the microphone to a PA system, a woman had been talking over him, and disrupting the sale, which he ran out of a building at his home in Tazewell.

“You couldn’t auction for that woman squalling, and going on,” T.J. said. “I told her to shut up. She said ‘I’ve been throwed out of better places than this.’ I said, ‘Don’t let the door hit you on the ass when you leave.’ Said it over the microphone. ‘Probably a bar room, what you’ve been thrown out of.’”

T.J. noticed that other people began listening to his story, drawing closer to the van to hear what’s so funny. He went into greater detail.

“I said, ‘You need to shut up so I can have a sale,’ you know?” he said. “That building I sold out of, every little noise – wasn’t it Roy – was louder?”

Roy nodded in agreement, although he was not there at the time.

“In the basement of my building, it just echoed in there,” T.J. said. “You could whisper in the back, and I could hear it up there. She was cackling, going on, and telling jokes or something. I said, ‘You need to quieten down a little bit.’ She started running that mouth. I said, ‘Don’t let the door hit you in the ass on your way out.’ She had me mad. You couldn’t embarrass this woman. No shame. She’s dead now. Her and her husband used to play Mr. and Mrs. Santa Claus at Walmart over there. She was one of them kind of women you couldn’t embarrass, you know?”

At this point, most of the group shared another laugh and dispersed. They went about setting up their own tables, exchanging remarks about the miserable weather, and seeing what the others had for sale.

T.J. continued his story. He said in a six-month period, his computer and accounts had been hacked eight times and he does not feel comfortable putting his finances online.

“They took our auctioneer license because we didn’t renew them on the computer,” he said. “We’ve been hacked and everything. You think I’m going to put any money out there on the line? State took it. If I decided to have one, I’d still have one. State can kiss my ass.”

Here, however, was another story. Showing greater deference to Mary Knight in the office, T.J. adheres more to her rules than those of the state of Tennessee, or so he said, concluding the conversation.

“At the flea market, it’s Mary’s way or the highway,” T.J. said.

She laughed at the comment. On this patch of land along 25 E, Knight sees that everyone is in compliance with not just her rules, but Tennessee law.

“They pretty much know that out here,” she said. “I don’t put up with a bunch of crap. They can either go by my rules or go somewhere else. They’re not written in stone like the Ten Commandments, and you can kindly bend with some of them – but a lot of them, no I don’t bend – and they know that.”

She said she stays firm on the most important tenets, like staying within the bounds of the law, and keeping the environment safe for children.

“I don’t allow anyone out here drinking,” she said. “I’m not going to have any drugs. None of the pornography on the tables. I just don’t allow none of that stuff. The world today—the kids can probably teach me a lot of stuff, but they’re not going to learn it here.”

Knight said that although every day is different in her business, she does not usually have to reiterate or enforce her rules. It takes a courteous, respectful, and diverse group of people to give her flea market the character and qualities hundreds of people enjoy each weekend.

She knows her vendors as intimately as they might know each other. Gesturing out the window of her office, she begins telling their stories as they file in early, preparing to set up for the coming weekend.

“God love him. I believe that’s that little guy…” She trailed off, watching as he parks his car.

“I really worry about him. Sometimes he comes down here. He’ll stay all night tonight, and he’ll stay, of course, tomorrow. Sometimes he stays Saturday night, and then leaves Sunday,” she said. “But he comes, and sometimes he’s come and had no money, had no food, and the people I was talking about who come in from Kentucky, they normally have got a little hot plate, and they cook on it, and they always fix him something to eat, too. Or different people around buy him something to eat.”

Knight said this, too, is what she loves about her market. Among herself and the vendors, there is a strong sense of community, loyalty, and mutual care.

“Most of the people are good people. If I have any problems it’s the people who are coming in, looking. They’re just here to agitate somebody,” she said. “Just like one old guy out here last year talked pretty rough to one of my female vendors down here, and she called me.”

Knight said she asked the woman if she could still see him, and to identify him. She pointed him out.

“I went down there,” she said, “and he was one of these guys who had the tattoos – I reckon people think those tattoos make them look tough – with the wife beater shirt on. I said, ‘Hey, I need to talk to you.’”

The man said, “Yeah, what do you want?”

Knight said, “Where’s your vehicle?”

He said, “You see that black truck right there?”

“Yeah, I see it,” she said.

“That’s mine.”

“OK. You can either walk to it, and get in it, and leave here, or I’ll drag you up there to it, and put you in it,” she said. “He was about to—I said, ‘Nope, don’t even start running your mouth to me. I’ve done heard from too many people what you said – what you did – so you’re out of here.’”

Knight smiled and said, with a laugh, “I might get whooped, but they’ll know I was there.”

Although she runs a tight operation, and all the sellers agree she keeps her market safe, Knight is no stranger to aggression.

“I had a guy, one day, pulled a knife on me,” she said, “and he said, ‘Give me that money.’ I said, ‘Yeah, I will,’ and I just reached behind my back, and pulled out a gun, put it between his eyes. I said, ‘Boy, you’ve come to a gunfight with a knife. You’re in bad shape.’”

“Oh, Mary, I’m just kidding!”

“I said, ‘I’m not.’”

Everybody out here knows that’s just not going to happen, Knight said, who has carried a gun starting sometime around the age of 12.

The market, with its covered sheds, food truck, and weathered wooden tables, has changed little since it began in 1981.

“I guess age has changed a lot more than anything,” she said. “It used to be an older generation, and now it’s pretty much all ages.”

She said with the shifting of age groups at her flea market, the merchandise has subtly changed.

“You had more of your antique dealers at that time,” she said, adding that most of the people dealing in antiques have died off.

“The younger generation, that means nothing to them,” she said. “All they want is the greenbacks. I see that all the time.”

Antiques can still be found at the I-81 Flea Market, being sold by people like Bob “Chief” Fletcher, who owns a bus at the edge of the property, and sells antique trunks, lamps, lighters, and bric-a-brac.

“We’ve got that bus full,” Chief said, gesturing to an early model tour bus behind him with seafoam green trim, artwork for curtains, and a bathtub out front. “There is no room to put it all out.”

Mary said antiques, such as old clocks or radios, do not always bring enough money, at a large enough scale, to justify their place in markets like hers.

“If you’ve got antiques – good antiques – you’re going to have to hold onto them, or put them in an antique store where they have consignment sales, where you can wait for the right buyer to come through.”

Knight said in the 1980s her vendors were mostly white, but over time shifted to include people of Hispanic origin.

She was told by one of her Hispanic vendors that, “we consider you one of us, because you’ve always taken care of us here.”

Knight responded, “Well, I’ll always take care of you here. Just because you’re Hispanic doesn’t mean somebody’s going to come out here and mess with you.”

She recalled a time in recent history when a hate group calling themselves the Minutemen tried to get started in Hamblen County.

“A lot of people act like they don’t even remember,” she said. “Now I’m like, my God, it’s not been that long ago. They tried to get a real big group started in Hamblen County. How can you not remember it? It was on the front page of the paper.”

Knight said the group had been circulating a newsletter, complete with a list of names of everyone involved in the organization.

“Well, I got the paper, and I told them – I said, ‘Let me tell you something, guys: If your name’s on this paper, right there’s the road. You need to hit it. The Hispanics are welcome here, so let’s get that straight now. You’re not going to come out here and cause trouble,’”

She said the group was attempting to blame the Hispanic population for coming into the county and taking their jobs.

“No, they didn’t take your jobs,” she said. “You’re too sorry to work.”

Knight said she has worked her entire life, beginning with a store owned by her parents, Charlie Hill’s Store. That store was torn down and later moved next to the Housing Authority on Sulphur Springs Road in Morristown, near the Boys & Girls Club.

“Most of the people around there were good people,” she said. “The ones we had the most trouble with were kids from the boys club.”

She said one evening someone came into her store to rob her while her father was sick. She was there by herself, with rollers in her hair, tending the store, when the boy came in armed, threatening to lock her in a walk-in cooler. She had to think fast.

“I’d done put all the knives back, because I’d cleaned the meat counter up, so I couldn’t just reach and grab one of them,” Knight said, “but I thought, ‘I’m not going to be locked up in no walk-in cooler.’ We got into a fight over the gun. Come to find out, he was on probation. [He came] from a good family in town, but you know. When he left, I had his gun.”

Another time, she said she had parked her car out of sight, near a house behind the store. Her parents were aging by then, and not around as much. To a would-be criminal, the place appeared empty.

“Here comes this old boy from across the street with a stocking over his head,” she said, laughing. “Well I just met him at the front door. You talk about running. He was gone!”

Now, as eastern Tennessee has calmed with age, and the perceived lawlessness of the region fades with time, modernity encroaches. The omnipresence of online reviews, remote work, and inklings of gentrification threaten to push Tennessee’s commercial landscape into a cold, glassy and sterile future.

But Knight says she is happy with her flea market, and has no plan to “upgrade” or “improve” the grounds, saying she likes it the way it is, as does Hamblen County, and so does the community.

“This is a flea market,” she emphasizes. “Everything is pretty smooth out here. I can’t ask for more than that.”

The I-81 Flea Market opens its 41st year on March 5, 2022.

This story appeared in Discover Hamblen County magazine.