Taxes Effective Tax Rate Reconciliation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Effective Tax Rate Reconciliation, Excess Tax Benefits	$ (28,279)	$ (13,836)	$ (35,171)
Effect of Biotix contingent consideration gain	0	(4,394)	0
Income Tax Expense (Benefit), at Federal Statutory Income Tax Rate	143,092	136,890	200,978
State and Local Income Taxes	499	2,787	376
Deferred Tax Benefit, net related to Swiss Tax Reform	(15,833)	0	0
Provisional one-time charge on US tax reform	0	3,597	71,982
Foreign Income Tax Rate Differential	18,546	12,710	(43,691)
Other Adjustments	2,260	1,493	3,776
Provision for taxes	$ 120,285	$ 139,247	$ 198,250
Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent		35.00%	35.00%