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Kathy Martinez is International Director and Deputy Director of the World Institute on Disability, Oakland, USA. She gives an overview of events in the U.S. and Canada that made the independent living movement possible. She also covers the basic philosophy of the U.S. IL movement, as well as emerging issues and trends that challenge the IL movement. Internet publication URL: www.independentliving.org/docs6/martinez2003.html. In the forthcoming English version of: Alonso, J. Vidal Garcia. 2003. "El Movimiento de Vida Independiente, Experiencias Internacionales." ("The Independent Living Movement: International Experiences.") Internet publication URL: www.independentliving.org/docs6/alonso2003.pdf (In Spanish).

Given the increasing number of older persons relative to the working age population, record level taxes and baby boomers’ demands for self-determination and quality of life, which changes might the Scandinavian welfare model have to undergo in order to deliver long term care to all who need it? In Sweden, direct payments for personal assistance are paid to mainly younger persons with extensive disabilities. In terms of perceived quality and cost per hour of service, direct payments have been found to be more efficient than traditional local government services. But would this favorable experience hold for all persons in need of assistance with the activities of daily living – regardless of age, diagnosis and minimum needs? What would be such a policy’s cost and effects on the labor market? How could it be financed? Would it threaten younger disabled persons’ relative favorable present situation? Today’s Swedish policy of cash payments for the purchase of personal assistance services might be of interest as a long term care solution for tomorrow’s older persons.

This article and the review comment were first published in “EPICADEC News” (from the Foundation Epilepsy Care Developing Countries, Leiden), October 2000, pp. 9-10, titled “Imran’s Djinn”. They are here reproduced with permission, after slight revision. The article concerns an Asian boy living in UK. His family had trouble using the health services, because of different concepts of Imran’s illness. One of Imran’s teachers met the family half way, respecting their beliefs and giving them time to digest a different approach to epilepsy and its treatment. A scientific reviewer comments on the story. Internet publication URL: www.independentliving.org/docs7/miles-christine2000.html