Social market economy emphasizes that while protecting competition and maximizing market mechanisms，the government should intervene appropriately to ensure social justice. The establishment of German long-term care services reflects the state’s emphasis on social justice. Since the system not only includes redistribution in the form of insurance benefits but also involves the provision of social services， market participation inevitably needs to be considered. The balance between social justice and market efficiency has been reflected in establishing the Pflege-Versicherungsgesetz. With the changes in society，the system continues to evolve，bringing a gradual skew in the balance between social justice and market efficiency. The rising proportion of personal burden coupled with the increasing trends toward marketization of professional care institutions have increased social inequality. Therefore，market efficiency has been placed in a more crucial position in the long-term care system，thereby weakening social justice to a certain extent. China should further improve institutional construction，financial sustainability，and service supply to balance social equity and market efficiency better.