In the Dvali-Gabadadze-Porrati (DGP) model, the ``self-accelerating'' solution is plagued by a ghost instability, which makes the solution untenable. This fact, as well as all interesting departures from general relativity (GR), are fully captured by a four-dimensional effective Lagrangian, valid at distances smaller than the present Hubble scale. The 4D effective theory involves a relativistic scalar $\ensuremath{\pi}$, universally coupled to matter and with peculiar derivative self-interactions. In this paper, we study the connection between self-acceleration and the presence of ghosts for a quite generic class of theories that modify gravity in the infrared. These theories are defined as those that at distances shorter than cosmological, reduce to a certain generalization of the DGP 4D effective theory. We argue that for infrared modifications of GR locally due to a universally coupled scalar, our generalization is the only one that allows for a robust implementation of the Vainshtein effect---the decoupling of the scalar from matter in gravitationally bound systems---necessary to recover agreement with solar-system tests. Our generalization involves an internal Galilean invariance, under which $\ensuremath{\pi}$'s gradient shifts by a constant. This symmetry constrains the structure of the $\ensuremath{\pi}$ Lagrangian so much so that in 4D there exist only five terms that can yield sizable nonlinearities without introducing ghosts. We show that for such theories in fact there are ``self-accelerating'' de Sitter solutions with no ghostlike instabilities. In the presence of compact sources, these solutions can support spherically symmetric, Vainshtein-like nonlinear perturbations that are also stable against small fluctuations. We investigate a possible infrared completion of these theories at scales of order of the Hubble horizon, and larger. There are however some features of our theories that may constitute a problem at the theoretical or phenomenological level: the presence of superluminal excitations; the extreme subluminality of other excitations, which makes the quasistatic approximation for certain solar-system observables unreliable due to Cherenkov emission; the very low strong-interaction scale for $\ensuremath{\pi}\ensuremath{\pi}$ scatterings.