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14. Segment Information Segment Profit Reconciliation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Goodwill, Impairment Loss	$ 0	$ 0	$ 282,000
Income before income taxes	4,907,638	2,261,081	512,659
Unrealized Gain on Securities	4,495,825	2,030,987	606,230
Operating Segments [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Income before income taxes	404,800	219,100	(116,800)
Segment Reconciling Items [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Unrealized Gain on Securities	4,495,800	2,031,000	606,200
Corporate, Non-Segment [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Income before income taxes	(15,700)	(12,900)	(10,400)
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	(1,800)	(2,200)	(2,900)
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	$ 24,500	$ 26,100	36,600
Clinical Diagnostics [Member]
Segment Reporting, Reconciling Item for Operating Profit (Loss) from Segment to Consolidated [Line Items]
Goodwill, Impairment Loss			$ 276,100

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