>long-term societal importance without bringing in any form of centralized resource allocation.
The onus is on the biomedicine industry to demonstrate it's capable of producing anything of societal importance because so far it's largely failed to deliver. There's nothing noble or scientific about throwing good money after bad into an industry that's continuously failed to deliver.
You'll note I didn't try to specify what was of import.
We can create mechanisms that enable more people to follow their own idea of what is important instead of merely what is lucrative. Not everyone will agree with the choices other people make, and it wouldn't eliminate money as a motivating factor, it would just slightly reduce the strength of that signal relative to other potential signals such as "I feel like I'm doing something meaningful."
Antibiotics? Vaccines?
More people living more after cancer diagnosis? (ref: https://www.cancer.org/research/acs-research-news/people-are...)