TL;DR: the foundation is apparently fairly closed. The reason for skepticism is that they spend a lot of money without a public decision making process. They spend more money than many countries on healthcare and if they decide to pull the plug on certain projects, those projects are going to have a very tough time.<p>I personally don't really see a need to worry or be skeptical. They've been doing this for over a decade and so far it's going great. I'd be grateful rather than skeptical about them spending so much money on projects that otherwise could not exist the way they do.