Goodwill and Intangible Assets Disclosure [Text Block] (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Goodwill	$ 50,697	$ 50,697
Intangible Assets, Net (Excluding Goodwill)	13,163	14,669
Amortization of Intangible Assets	1,506	1,333
Specialty Health Segment Member
Goodwill, Acquired During Period		9,124
Finite-lived Intangible Assets Acquired		5,880
Amortization of Intangible Assets	$ 1,506	$ 1,333