Dear Rich Skrenta. I really dont think we need another DMOZ.
Most of what you stated is simply not true:
You used "medical" as example, but obviously that is a loaded example.
If OnDemand publishes a piece on how to make a pink tutu dress for your pet chihuahua, I don't think that Vogue, Cosmo, or Better Homes & Gardens has something that answers that question.
Not all lead generation is spam, if they add value. Even universities need to pay for marketing expenses, and not necessarily just through Google ads; although thats the way I'd prefer it.
If you are just going to get mad at Google, do so, but stop trying to put us down with your spammy tactics.