Re “First, do no harm’’ by David Torchiana, president and CEO of Partners HealthCare (Opinion, Dec. 19): In understanding Partners, a touch of history may be relevant. There never was a need for a “Partners.’’ It was created to make an alliance between Massachusetts General Hospital and Brigham and Women’s Hospital — but also to make money.

American health care at first was a two-party system: doctor and patient. The next step was a third party: private insurance. Partners was born as a new third party, wedged between doctor-patient and private insurance (which became “a new 4th party’’). Partners became a middleman and fee broker between doctor-patient-hospital and private insurance.

No wonder this added corporate giant added to health care costs, and has recently suffered record losses from ventures such as the installation of a new electronic medical records system and from running its own insurance company, Neighborhood Health Plan.

There’s no need for a “Partners.’’ The need, and solution, is for a national single-payer Medicare for all. Many, if not most, doctors want it. And ask any of us Medicare insurance patients: It’s cheap, and it works.

Dr. Samuel Shem

Newton

The writer is the author of the novel “The House of God’’ and is professor of medicine in medical humanities and psychiatry at New York University Medical School.