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.