It looks like Obama screwed the middle class big time. This is a huge income redistribution scam.
Same as it is with a tourist visa --I just realized that I get an Obamacare waiver when I visit Panama.
Something else that just occurred to me is that w/ medical tourism being so big that Panamanian doctors and dentists ought to park a Panamanian flagged hospital ship off the 3 mile limit to be just outside of U.S. tort liability jurisdiction. They'd make a fortune and save thousands of lives.