Eleanor Kinney was a giant in health law scholarship, the master of Medicare and Medicaid, the critic of medical malpractice reforms, and the scholar of government action in health care. She was someone a fledgling health law scholar would turn to understand why the world of health care regulation in the United States was shaped the way it was.

I want in this brief essay to discuss two related themes that Eleanor developed masterfully in her work on Medicare: first, the evolution of the program from a benefits administration payment program to today's P4P regulator; and second, her constant concerns about beneficiaries and the quality of care they receive under Medicare, including fair treatment for adverse events. My own work has looked at the limits of tort as a compensation tool and more recently on the struggles of hospitals caught in a complex world of Pay for Performance (P4P) reimbursement metrics combined with Artificial Intelligence (AI) tools of detection of patient injury, and my own ideas have benefited from her excellent scholarship.