This chapter analyses the development of cash-for-care programs across OECD countries, their effects and their future perspectives. A major commonality of these programs is that they emphasize choice for users, a concept that can be variously declined. With regard to the choice idea behind cash-for-care programs, the chapter distinguishes among three perspectives: market orientation, empowerment orientation and family orientation. After having discussed these three perspectives, the chapter examines how they can be translated into different policy designs and what are the implications. The comprehensive review of several national experiences carried out shows that cash-for-care programs are often put forward as a measure that strengthens choice and autonomy of the user. In reality, cash-for-care in combination with limited public coverage and limited social rights in terms of services and the individual ability and willingness to pay can lead to re-familisation and create considerable risks for professionalization, for the quality of care work relationships and for the quality of care.
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