> The only person I can think of who didn't fall into this bizarre pattern is Gates, who just funds a foundation that hands out grants to various organizations, mostly non-profit and NGO, who might get things done.

I think you make some insightful points about the "weird pattern", but I don't think Gates is a good counter example. He, his wife, and his foundations seem as top-down/central-planning as anyone else, he just isn't as outspoken about it.