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1. Significant Accounting Policies Property, Plant and Equipment (Details) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Property, Plant and Equipment [Line Items]      
Restricted investments $ 5,560 $ 5,560  
Retained earnings 9,268,012 5,470,779  
Other assets 86,723 79,636  
Prepaid Taxes 5,800    
Income Tax Expense (Benefit) (1,101,371) (502,406) $ (147,045)
Intangible Assets, Net (Excluding Goodwill) $ 199,497 $ 145,525  
Minimum [Member]      
Property, Plant and Equipment [Line Items]      
Finite-Lived Intangible Asset, Useful Life 3 years    
Minimum [Member] | Building and Building Improvements [Member]      
Property, Plant and Equipment [Line Items]      
Property, Plant and Equipment, Useful Life 10 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]      
Property, Plant and Equipment [Line Items]      
Finite-Lived Intangible Asset, Useful Life 20 years    
Maximum [Member] | Building and Building Improvements [Member]      
Property, Plant and Equipment [Line Items]      
Property, Plant and Equipment, Useful Life 50 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