Nashville must look for "more viable long-term options" to fund the city's cash-strapped safety-net hospital after years of costly subsidies and loan extensions, Mayor Karl Dean wrote in a letter to the hospital's board chairman. Dean told Metro Hospital Authority Chairman Waverly D. Crenshaw Jr. that his administration would look at ways to reduce Metro's expenses in the operation of Nashville General Hospital at Meharry. The city gave the hospital authority a $47.3 million subsidy—reflecting a 5% cut—for the fiscal year that started July 1. General Hospital regularly struggles because so many of its patients have little or no health insurance, making it tough to get reimbursed for many of the services it provides.