It comes down to a business decision for these organizations. Even people that have a hard line moral stance on this are suddenly faced with not the question of should I pay the ransom or fund the IT department, it is should I pay the ransom or go out of business.
An obvious example is a hospital system, where suddenly ambulatory care has to be diverted, Epic is down, and they're scrambling with DR procedures to dispense medication and track everything on paper while not being able to treat cancer patients because radiation oncology is impacted. With lives on the line, there is a different kind of pressure outside of the business aspect. Even for a small mom and pop situation, their backups have been destroyed, and they often cannot function as a business without a certain set of critical data that is far more costly, if even possible, to rebuild, and financially unfeasible. They could just close the business and feel good that they didn't pay the bad guy, but that can have serious economic impacts to employees and clients that rely on them. The number of organizations getting hit by ransomware is massive, compounding the problem.
Unfortunately, even organizations with massive IT and security budgets are still vulnerable to these things. It's a tough situation, and from my visibility, less victim organizations have had to pay over the last couple years, but still more than 23%.