From your story, it sort of sounds like doctors are the villains. Isn't it their job to choose the best medicine for their patients. If an uninsured patient asks for a cheaper older one, then they should be prepared to find that. But then perhaps you could pass the buck to the patient for not finding a doctor willing to search for cheap drugs. It just goes round in circles.

For insulin, is there even such as thing as "better"? It's not treating a disease with some probability of success that you want to maximize. It either works or it doesn't. At least that's my limited understanding.