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      When Medical Problems Turn Financial

      Wes and Katie Covington of Smyrna, Tenn., were already in debt from a round of fertility treatments when complications with her pregnancy and surgery on his knee left them with unmanageable bills. Their 1-year-old daughter, Lizzie, sits in a rocking chair in the apartment they rented after losing their home in bankruptcy proceedings.

      At the bankruptcy court in Nashville, lawyers provided a spectrum of estimates for the share of cases in Middle Tennessee where medical debt was decisive, from 15 percent to 50 percent. But many said they felt the number had been growing. “This has really become the insurance system for the country,” said Susan R. Limor, a bankruptcy trustee who calculated that 13 of the 48 Chapter 7 liquidation cases on her docket one recent afternoon included medical debts of more than $1,000.

      Photo: Josh Anderson for The New York Times