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14. Segment Information Segment Profit Reconciliation (Details) - USD ($) $ in Thousands | 12 Months Ended
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Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items] |  |  |
Goodwill, Impairment Loss | $ 282,000 | $ 11,500 |
Income before income taxes | 512,659 | 97,805 | $ 41,560
Unrealized Gain on Securities | 606,230 | 0 | 0
Operating Segments [Member] |  |  |
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items] |  |  |
Income before income taxes | (116,800) | 106,300 | 39,800
Segment Reconciling Items [Member] |  |  |
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items] |  |  |
Unrealized Gain on Securities | 606,200 | 0 | 0
Corporate, Non-Segment [Member] |  |  |
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items] |  |  |
Income before income taxes | (10,400) | (10,100) | (7,500)
Foreign Currency Gain (Loss) [Member] | Segment Reconciling Items [Member] |  |  |
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items] |  |  |
Income before income taxes | (2,900) | (9,100) | (4,500)
Other Nonoperating Income (Expense) [Member] | Segment Reconciling Items [Member] |  |  |
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items] |  |  |
Income before income taxes | 36,600 | 10,700 | $ 13,800
Clinical Diagnostics [Member] |  |  |
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items] |  |  |
Goodwill, Impairment Loss | $ 276,100 | $ 2,800 |

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