I don't think money is a good proxy for "adding utility to people's lives". It's a good proxy for "good at playing the money game". A nurse won't be paid $1B if she saves a CEO's life, and he is able to go and make his company billions as a result. A clever business person might, if she saves the CEO in some other aspect, as she can setup a provision first.

That being said, I don't think money has much to do with merit, either. It's just the output of a function that you are either good at optimizing or not.

Yes, supply comes into it too.

A nurse will be paid a substantial sum if she is one of very few that can save the CEO's life.

The CEO can die and the company will continue functioning 95% as well. Or maybe 105%, or 10%, or 1,000%.

If he's eating the shareholder's money like that, they should fire him.