One of the car dealers here has yet to receive a single dollar from the feds for the cash for clunkers program. It was supposed to take 10 days maximum from the time of filing the paperwork after each sale for the federal funds to land in the dealer's bank account. They are currently owed about a quarter of a million dollars. They are confident that they will get paid, someday.
This was/is a very simple program. The federal government couldn't even get this right. Health care and health insurance are quite a bit more complicated. Anyone who thinks the government can run those types of programs efficiently is delusional. If this stuff passes, it will be the single largest waste of borrowed money in world history.