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Author: John O'Brien

There are hundreds, probably thousands, of activists and leaders around the world who have visited the City of Madison and Dane County, which sits in the middle of the vast US State of Wisconsin. We visited because we had heard that people there had worked, for decades, to establish the highest standards in support, inclusion and community life for people with intellectual disabilities.

John O'Brien was one of those who both inspired some of these positive developments and who helped share their learning with an international audience. However success - in public service - does not guarantee survival, especially when local democracy comes into conflict with the lobbying of the private healthcare and insurance systems. And this is not just a US problem, as colleagues in the UK and Finland are finding. The invasion of decent and effective public services, by managed care systems is well underway around the world. The result is likely to be the abandonment of the highest standards and a loss of integrity around the achievement of declared public policy goals.

This fascinating paper by John O'Brien helps both document what was achieved in Dane County and it explores the means by which those achievements were put under threat. This a critical document for future leaders, because it shows that positive, human rights-based supports, are entirely possible. But it should also help us spot some of the strategies that we must defeat if we are to push back commodified systems of care and to overcome the threat of managed care. 

Read and download the free pdf in your browser here.

The publisher is John O'Brien.

Valedictory © John O'Brien 2018.

All Rights Reserved. No part of this paper may be reproduced in any form without permission from the publisher except for the quotation of brief passages in reviews.