The German healthcare system exhibits a notable resistance to reform. For years, significant healthcare reforms have been announced by politicians, which often shrink to the scale of minor adjustments. The healthcare reform of 2000 serves as a prime example of a reform that failed in essential aspects due to political feasibility and implementation issues. By utilizing the concept of veto players as blocking factors within coalition governments, the Bundesrat, and the healthcare sector itself, it can be demonstrated that the main barriers to reform that led to the failure of the healthcare reform of 2000 were found in the Bundesrat and in the self-administration of service providers and funders in the healthcare system. Hypotheses regarding the power of physicians as a barrier to reform are largely disproven.