Sometimes the most profound lessons come wrapped in the most harrowing circumstances. This week, a single administrative decision at Israel's Soroka Medical Center transformed what could have been a massacre into a manageable crisis—and it perfectly illustrates a risk management principle I teach my clients every day.
The Formula That Saves Lives (and Businesses)
Risk mitigation isn't rocket science, though it might as well be given how often people ignore it. The formula is elegantly simple:
If the cost of mitigation is less than your net risk, you mitigate. If it's not, you accept the risk. It's mathematical clarity in an uncertain world.
Most people struggle with this equation because they're terrible at estimating both variables. They either catastrophize unlikely events or dismiss genuine threats because "it hasn't happened yet." But sometimes—just sometimes—someone gets it exactly right.
When the Equation Saved 1,000 Lives
Enter Moshe Bar Siman-Tov, Director General of Israel's Health Ministry. As tensions escalated between Israel and Iran, Bar Siman-Tov faced a choice that would make most administrators reach for their liability insurance policies.
Soroka Medical Center in Beersheba serves over one million residents across southern Israel. It's a massive complex with more than 1,000 beds—exactly the kind of critical infrastructure that becomes a target during conflicts. Bar Siman-Tov could see the writing on the wall, or in this case, the missiles in the air.
His calculation was brutal in its simplicity:
- Cost of the event: Direct missile strike on an occupied hospital ward = hundreds of casualties, potential total facility loss
- Likelihood: With Iran launching ballistic missiles at Israeli targets, a hit on major infrastructure wasn't a matter of "if" but "when"
- Cost of mitigation: Evacuate vulnerable hospital sections, move patients to protected areas, implement emergency protocols
The math wasn't even close.
The Decision That Defied Murphy's Law
Bar Siman-Tov ordered the evacuation of Soroka's older surgical ward building and other vulnerable areas. Patients were moved to underground facilities and reinforced sections. Staff implemented full emergency protocols.
Then, early Thursday morning, an Iranian ballistic missile slammed directly into the evacuated surgical ward.
The building that housed that ward? Gone. Roof collapsed, windows blown out across the complex, debris everywhere. The missile caused extensive damage to the facility, with heavy black smoke pouring from upper floors and blown-out windows throughout much of the complex.
The casualties from this direct hit on a major hospital? 71 people with minor injuries, mostly from broken glass and blast effects. Zero deaths.
As hospital director Prof. Shlomi Kodesh explained, "A missile hit the old surgical ward building at Soroka. It's a relatively old building that had been evacuated in recent days."
The Cost of Getting It Right
Bar Siman-Tov's decision wasn't free. Evacuating hospital sections during wartime is logistically complex and expensive. You're moving vulnerable patients, disrupting medical procedures, and operating in emergency mode. The mitigation cost was substantial.
But compare that to the alternative scenario: a direct missile strike on an occupied ward filled with patients, medical staff, and visitors. We're talking about potential casualties in the hundreds, not to mention the complete loss of a critical medical facility serving a million people.
As Bar Siman-Tov himself noted when surveying the damage, "A much heavier disaster and much heavier damage were avoided here, especially in human life. There was good decision-making here on the part of all of us to make sure that we were prepared."
Why Most People Fail at Risk Math
Here's what separates competent risk managers from the "it'll never happen to us" crowd: Bar Siman-Tov didn't need perfect information to make the right decision. He had enough data to run the calculation and the authority to act on it.
Behavioral economists have a field day with how badly humans assess risk. We're hardwired with cognitive biases that turn us into walking risk-assessment disasters. The availability heuristic makes us overweight recent, vivid events while ignoring statistical realities. Optimism bias convinces us that bad things happen to other people. And loss aversion makes us irrationally cling to the status quo, even when change would clearly benefit us.
Most people I work with—whether they're running businesses or families—get paralyzed by the same equation. They either:
- Underestimate the cost of the event ("A lawsuit can't cost that much, right?" or "We're young and healthy")
2. Underestimate the likelihood ("We've never had a problem before" or "That only happens to other families")
3. Overestimate the cost of mitigation ("Insurance/legal compliance/proper contracts are too expensive" or "Estate planning is for rich people")
The result? They skip the mitigation and hope for the best. Sometimes they get lucky. Sometimes they don't.
The Legal and Life Parallels
In my practice, I see this same risk equation play out constantly in both business and family contexts, usually with less dramatic but equally predictable results:
In business:
- The LLC that skips an operating agreement because "we're all friends"
- The nonprofit that avoids proper board governance because "it's too much paperwork"
- The business owner who uses DIY contracts because "lawyers are expensive"
In families:
- The parents who never discuss their financial situation with adult children
- The couple who assumes they'll both always be healthy and capable of making decisions
- The family that keeps all important documents in dad's filing cabinet that only dad knows how to navigate
- The homeowners who figure they'll "deal with insurance later" after that first claim
- The parents who never update beneficiary designations after major life changes
Each of these decisions represents the same flawed risk calculation that could have killed hundreds of people at Soroka Hospital. They're betting that the low cost of doing nothing beats the higher cost of proper mitigation.
Family risk mitigation isn't about elaborate legal documents or expensive insurance policies. Sometimes it's as simple as having conversations, updating a beneficiary form, or making sure someone else knows where you keep the passwords. The tragedy isn't that families don't plan—it's that they don't recognize how little it would actually take to prevent most family financial disasters.
Making the Math Work for You
Bar Siman-Tov's success came from recognizing three critical factors:
- The cost of the worst-case scenario was catastrophic (mass casualties)
2. The likelihood was increasing daily (active missile strikes)
3. The mitigation cost was manageable (evacuation and emergency protocols)
When you're evaluating risks—whether in your business or your family—ask yourself the same questions. What's your worst-case scenario? What's the real likelihood? What would mitigation actually cost?
Most of the time, you'll find that proper legal structure, appropriate insurance, and competent professional advice cost far less than rolling the dice on disaster. But the mitigation doesn't always require elaborate solutions. Sometimes a family conversation prevents more chaos than a complex trust. Sometimes updating a beneficiary designation solves problems that expensive legal documents can't touch. Sometimes the right answer is "you're already covered, just keep doing what you're doing."
The math isn't complicated. We just let our biases convince us otherwise.
The Bottom Line
Bar Siman-Tov didn't have a crystal ball. He couldn't predict exactly when or where a missile would hit. But he understood that risk mitigation isn't about perfect prediction—it's about making rational decisions with imperfect information.
The result speaks for itself: what officials called "a great miracle" was actually just good risk management. When the unthinkable happened, the groundwork was already in place.
Your business probably won't face incoming ballistic missiles, and your family probably won't face the specific crisis that requires immediate evacuation. But both will face lawsuits, regulatory changes, partnership disputes, health emergencies, incapacity, and a thousand other risks that can destroy what you've built or leave your loved ones in chaos. The same mathematical principle applies: if the cost of mitigation is less than your net risk, you mitigate.
The alternative is hoping that lightning won't strike twice, missiles won't find their target, and Murphy's Law will make an exception just for you.
In my experience, hope isn't much of a business strategy.
Need help calculating the real costs of risks to your business or family? Let's talk. Because unlike incoming missiles, most disasters are entirely preventable with proper planning.
