Market-oriented restructurings of long-term care policies contribute significantly to the aggravation of care workers’ situations. This article focuses on the effects of broader long-term care policy developments on market-oriented reforms. Germany, Japan and Sweden are three countries that have introduced market-oriented reforms into home-based care provision embedded in distinct long-term care policy developments. Conceptually, this article draws on comparative research on care to define the institutional dimensions of long-term care policies. Empirically, the research is based on policy analyses, as well as on national statistics and a comparative research project on home-care workers in the aforementioned countries. The findings reveal the mediating impact of the extension and decline of long-term public care support and the corresponding development of the care infrastructure on both the restructuring of care work and the assessments of the care workers themselves.