You will have to choose between breakeven and dividends. I cannot see a middle ground, because today’s small dividends will become tomorrow’s bigger dividends, then society will get addicted to free money (as bullshit an idea as there ever was) and demand evermore and then where will you be but right back where you started.
But more to the spirit of your essay, it is to say that profits have become unmoored from value. I would be much more careful in disparaging the value of improvements in insulin production and in insulin itself. The production itself is relatively simple… in theory, most molecular biology labs would be able to homebrew it without too much difficulty (yes, it is slightly more complicated than a straight ferment and purify, even so). The devil is in the details of making it medically usable and a lot of time, effort and money has been spent on that. In addition, straight insulin is not the best behaved of materials and a great deal of investment has yielded large, solid benefits.
Does that justify prices now the US? Not in the least. But it’s because of the way the rules are written, and even more because of the people chosen to enforce these rules. Corporations are what we make them to be. They can be brought to heel, as China has done.