Dependencies of Long-Term Care Policy on East-West Migration: The Case of Germany

Abstract

This contribution reconstructs the policy shift from a Bismarckian “low road” to a “higher road” of long-term care (LTC) policy in Germany. We argue that this policy change is deeply intertwined with migration to uphold and transform LTC policy. Cash benefits did not just stabilise family care, but are increasingly used to establish a “migrant-in-the-family” model. Moreover, while the marketisation of care services led to an expansion of commercial services, this process increasingly depended on migrant carers. Policy measures to improve working conditions in formal care were only initiated when ever-growing demands could not be met by migrant workers. At the same time live-in arrangements are only cautiously regulated. Reflecting the familialistic legacy, provision of care by women (paid/unpaid, formal/informal, professional/semi-professional) has become more stratified.