by Kim Macqueen

Prof. Marie Cowart

It's fair to say that when Marie Cowart looks, it's at the proverbial big picture.

The Florida State professor of urban and regional planning began her career in the clinical setting, serving in supervisory positions in various hospitals during the 1960s. She picked up a master's degree from Tulane University in 1966, then was taught nursing for several years in the '70s. She enjoyed that, but it wasn't exactly where she wanted to be.

"Being involved in one part of something is not nearly as exciting to me as understanding how the whole system works," she says. "I knew in the back of my mind that I really wanted to move into policy and broader system issues."

Cowart had already racked up a long list of publications and shifted her focus to public policy by the time she left Columbia University with a Ph.D. in Health Care Administration in 1982. So when she got the opportunity to join the growing faculty at FSU's new Institute on Aging three years later, she leapt at it. She's been there for 11 years and counting, and it feels like home.

The lauded teacher and scholar spends her days tackling many different aspects of health-care delivery, one of the most--if not the most--pressing modern social problems in the nation and state. She's got a dizzying list of state contracts to investigate a broad array of research topics, only the most recent being the state of long-term care in America, training for public health employees, control for chronic disease and disaster preparedness for the elderly. She's authored or edited six books and has written extensively on health care and public policy for a wide array of academic journals.

Cowart knows her subject intimately and is frustrated by recent trends in health care that have seemingly turned it into a profit-making game at the expense of the people it purports to help.

"Our health care systems seem to be going backwards and being dismantled," she notes. "They're being shaped in a fragmented way, instead of with an overall plan. Market forces drive health care now more than the rational needs of the population does."

Florida's huge elderly population and the current Federal Medicaid fights make this the right time and place to study the systems that provide health care--or deny its access through lack of funding--to the state's many varied populations. Cowart has worked with the state of Florida to provide guidance to those making several of the state's laws and credits its health care system for the elderly, which she says is well-designed. But such services simply aren't funded at the level necessary to fully carry out their missions.

"The number of state dollars to take care of the elderly is not increasing markedly. So even though the actual delivery system for services is much better than it was 10 years ago, fewer services are being delivered. We're not taking really good care of our elders."

On the national level, Cowart says, "More and more people are uninsured these days. I think we're going to see more medical catastrophes for individuals before there's a solution. And we don't seem to have the leadership at the federal level to want to correct this situation."

Yet Cowart exudes enthusiasm for understanding and perfecting this mammoth system and training her students to do the same.

"If you worked in an emergency room, you'd get to see results right away. Policy work doesn't have much immediate gratification--it's long-term. There's a tremendous amount of satisfaction in sharing new insights through research, and preparing students to do research. Then they call me three years out in practice and tell me what they're doing, and I think, 'wow, I can't believe it.'"

Though Cowart's gifts would probably be lauded in Washington, she's much happier at Florida State, in what she calls a "cutting edge" state in terms of the way it's being called upon to handle its health-care problems. She brings her administrative philosophy and broad political background to campus politics--this spring she was elected president of the faculty senate.

"I guess that's part of my 'macro' view. I like knowing how the whole university operates and being involved in the bigger system. That's what keeps me fresh."