Bob,
I agree to your point on "catching up" and the message that bridging a demand-supply gap with cheaper (read service) options is NOT innovation....
However, what I do believe is that these organizations actually produce a small % of people who turn out to be the mavericks ...basically, the outcasts of the service organizations who in my fond hope will be the eco-system for innovation.
In some sense, I'm using the point that historically Bangalore's own rise within the IT space has a lot to do with the following 2 points
a. There were relatively active educational centers (would stop short of calling them institutions in deference to your reference to Cambridge)
b. Had a good base engineering skills structure (community respect) that came out of all the public sectors and the defence labs
IMHO, what has actually hindered entreprenuership development (more than governmental / structural support) is our CULTURAL abhorence to risk. I include my own generation which was fed & brought up on the mantra that an individual has "made it" in life if he / she gets a job in a Public sector or a Bank.
It is only the success stories and an appreciation of risk over the last 2 decades that seems to have started a small transformation. The real "kick" in the graph would be when people (as a society) come to terms with a failed enterprise and it will be ok to fail and learn ?
Off topic : I'm sure there are others who can help in the E-health side more than I can, but, would be glad to be involved in anything to do with Energy efficiency (your note on Electricity)
Rgds
Ravi.