Douglas, thank you for these thoughtful comments.
On the subject of Elsevier you may have seen the latest from Timothy Gowers on his blog http://gowers.wordpress.com/2014/04/24/elsevier-journals-some-facts/ As well as exposing the high cost of journal subscriptions he makes some comments which suggest that Elsevier is indeed taking the open access charges in addition to the subscription charges. They justify this by pointing out that the total number of non-open access papers in their journals is still increasing.
Of course you are right that peer-review is not the only thing or even the most important thing that needs to be addressed to save humanity. My point is rather that its importance is greatly underestimated compared to other things that people may highlight.