CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands	6 Months Ended
	Jun. 30, 2011	Jun. 30, 2010
Cash flows from operating activities:
Net income	$ 124,865	$ 375,029
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization	136,084	126,307
Provision for doubtful accounts	145,985	148,403
Deferred income tax provision (benefit)	8,890	(3,702)
Stock-based compensation expense	35,192	28,575
Excess tax benefits from stock-based compensation arrangements	(4,786)	(4)
Provision for special charge	236,000	0
Other, net	6,430	11,266
Changes in operating assets and liabilities:
Accounts receivable	(194,057)	(193,168)
Accounts payable and accrued expenses	(74,546)	(84,590)
Settlement of special charge	(241,000)	0
Income taxes payable	39,323	41,780
Other assets and liabilities, net	1,703	(1,512)
Net cash provided by operating activities	220,083	448,384
Cash flows from investing activities:
Business acquisitions, net of cash acquired	(1,136,380)	0
Sale of securities acquired in business acquisition	213,541	0
Capital expenditures	(78,624)	(88,848)
Increase in investments and other assets	(6,503)	(3,196)
Net cash used in investing activities	(1,007,966)	(92,044)
Cash flows from financing activities:
Proceeds from borrowings	2,433,329
Repayments of Debt	(1,108,786)	(1,487)
Purchases of treasury stock	(835,001)	(425,773)
Exercise of stock options	97,216	40,174
Excess tax benefits from stock-based compensation arrangements	4,786	4
Dividends paid	(32,930)	(36,430)
Distributions to noncontrolling interests	(16,850)	(16,830)
Other financing activities	(18,964)	(2,366)
Net cash provided by (used in) financing activities	522,800	(442,708)
Net change in cash and cash equivalents	(265,083)	(86,368)
Cash and cash equivalents, beginning of period	449,301	534,256
Cash and cash equivalents, end of period	$ 184,218	$ 447,888