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1. Significant Accounting Policies Property, Plant and Equipment (Details) - USD ($)
$ in Thousands
 3 Months Ended 12 Months Ended
Dec. 31, 2017
Sep. 30, 2017
Jun. 30, 2017
Mar. 31, 2017
Dec. 31, 2016
Sep. 30, 2016
Jun. 30, 2016
Mar. 31, 2016
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
Jan. 01, 2018
Jan. 01, 2017
Property, Plant and Equipment [Line Items]                          
Long-term Debt and Capital Lease Obligations $ 1,830,439       $ 1,828,581       $ 1,830,439 $ 1,828,581      
Other assets 94,949       47,852       94,949 47,852      
Prepaid Taxes 14,500               14,500        
Equipment 971,140       908,659       971,140 908,659      
Deferred income taxes 222,209       225,299       222,209 225,299      
Income Tax Expense (Benefit) 36,800 $ (8,600) $ 3,900 $ (7,700) 9,500 $ (5,600) $ (10,300) $ (9,200) $ 24,444 (15,560) $ (36,608)    
Minimum [Member] | Software [Member]                          
Property, Plant and Equipment [Line Items]                          
Property, Plant and Equipment, Useful Life                 3 years        
Minimum [Member] | Building and Building Improvements [Member]                          
Property, Plant and Equipment [Line Items]                          
Property, Plant and Equipment, Useful Life                 15 years        
Minimum [Member] | Reagent Rental Equipment [Member]                          
Property, Plant and Equipment [Line Items]                          
Property, Plant and Equipment, Useful Life                 1 year        
Minimum [Member] | Equipment [Member]                          
Property, Plant and Equipment [Line Items]                          
Property, Plant and Equipment, Useful Life                 3 years        
Maximum [Member] | Software [Member]                          
Property, Plant and Equipment [Line Items]                          
Property, Plant and Equipment, Useful Life                 12 years        
Maximum [Member] | Building and Building Improvements [Member]                          
Property, Plant and Equipment [Line Items]                          
Property, Plant and Equipment, Useful Life                 30 years        
Maximum [Member] | Reagent Rental Equipment [Member]                          
Property, Plant and Equipment [Line Items]                          
Property, Plant and Equipment, Useful Life                 5 years        
Maximum [Member] | Equipment [Member]                          
Property, Plant and Equipment [Line Items]                          
Property, Plant and Equipment, Useful Life                 12 years        
Adjustments for New Accounting Pronouncement [Member]                          
Property, Plant and Equipment [Line Items]                          
Long-term Debt and Capital Lease Obligations (120,100)               $ (120,100)     $ (17,000) $ (300)
Other assets                       $ (17,000)  
Scenario, Adjustment [Member]                          
Property, Plant and Equipment [Line Items]                          
Long-term Debt and Capital Lease Obligations         (7,599)         (7,599) (200)    
Equipment         (10,467)         (10,467)      
Deferred income taxes         2,380         2,380      
Income Tax Expense (Benefit) $ 4,600 $ 2,900 $ 0 $ 0 $ 1,900 $ (1,300) $ (1,400) $ (1,300)   (2,125) (3,854)    
First Tax Misstatement [Member] | Scenario, Adjustment [Member]                          
Property, Plant and Equipment [Line Items]                          
Income Tax Expense (Benefit)                   $ 200 $ 181