Over the years, I've evolved a somewhat heretical but time-and mind-saving approach to books, articles, editorials that deal with weighty matters. More often than not, by beginning at the end and contemplating the conclusions, one can determine if it's worth going through the whole to get there.
By and large, the answer to the question "How do large institutions survive?" is "They don't!" The vast majority of large modern-day institutions some of them extremely vital to the functioning of our complex civilization simply fail to exist in the first place.