Abstract: Long-term care insurance system is an important public policy arrangement to protect people's livelihood. The study found that there are many problems in the current long-term care insurance system in China, such as the conflict between value rationality and instrumental rationality, the lack of democracy in the system procedure, the new injustice of the system content, and the lack of people-oriented concept. In order to improve the fairness of the long-term care insurance system, it is suggested to coordinate the value rationality and instrumental rationality to improve the publicity of the system objectives, to perfect the democracy of the system procedure in the five-in-one system, to improve the fairness of the system content in the social equity security system, and to change the development thinking to improve the people-oriented system concept.