Daron, I thought you could do that with (entmake), too. But after trying a number of different things, I cannot get it to work.
However, turning to our relatively new friend, ActiveX, we CAN do this:
(vlax-invoke (get_space) 'insertblock '(0.0 0.0 0.0) (findfile "car.dwg") 1.0 1.0 1.0 0.0)
where (get_space) is just a small helper function to get the current space and I used the (findfile "car.dwg") as I knew it existed in my support path.
tcdan, this would be used to insert a block that is not yet defined in the drawing and is probably too big to try defining the entire thing with code.