Every lender I talk to asks if I'm refinancing to "pay off debt" or "for home improvements". 

Medical debt has less weight than credit card debt or utility debt for example.

Someone with $10K in savings with zero debt, or someone with $20K in savings and a small car payment around $250-$300/month?

Is it use the money to pay off debt? OR

If you invest it powers of compounding will almost guarantee you make more than the 5-7% juice on student debt or a mortgage.

My question is, does there come a point where I need to focus on paying down my debt or do I keep purchasing 1-2 properties a year and focus on the positive cash flow?

That's why garnishees are often the only way of collecting money from these debtors, and in one company I owned, I have 3 employees under garnishment, 2 for debts, and one for child support.In NY State, garnishees can only be done on 15% or salary, and for child support, 25%, and only if the salary exceeds a certain amout.

Biggest thing with this is going to be you and your ability to prove to the seller you are a safe debtor.

While your score is an at-a-glance measure of how risky of a debtor you’re calculated to be, the profile is a more detailed look at whether or not it could be a fiscally sound decision to offer you a loan.

The next question then is, Has the Trustee issued a "Non Recourse Debt" against both the First and the Second loans or did the debtor reaffirm the debt?