A Social Guarantee for Adult Social Care starts by acknowledging that this is an area of need where markets inevitably fail to protect all but the wealthy. So it must be dealt with collectively. Germany’s long-term care insurance scheme features universal social rights and strong cost-containment. It sees long-term care as a social risk requiring social protection and has cross-party political support. The overall budget, contribution rates, ceilings, benefit levels and eligibility criteria are fixed by Federal law. Membership of the scheme is compulsory. Over 25 years, despite population ageing, scheme expansion and rising benefits, members’ contributions have increased by only 0.8% of salaries.