CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands	9 Months Ended
	Sep. 30, 2011	Sep. 30, 2010
Cash flows from operating activities:
Net income	$ 306,758	$ 582,785
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	209,431	190,444
Provision for doubtful accounts	214,373	222,882
Deferred income tax provision (benefit)	3,255	(4,673)
Stock-based compensation expense	50,789	45,042
Excess tax benefits from stock-based compensation arrangements	(4,575)	(24)
Provision for special charge	236,000	0
Other, net	5,732	14,322
Changes in operating assets and liabilities:
Accounts receivable	(271,113)	(279,879)
Accounts payable and accrued expenses	(84,408)	(26,646)
Settlement of special charge	(241,000)	0
Income taxes payable	122,061	19,095
Other assets and liabilities, net	10,425	15,110
Net cash provided by operating activities	557,728	778,458
Cash flows from investing activities:
Business acquisitions, net of cash acquired	(1,298,518)	0
Sale of securities acquired in business acquisition	213,541	0
Capital expenditures	(117,879)	(136,291)
Decrease (increase) in investments and other assets	798	(3,543)
Net cash used in investing activities	(1,202,058)	(139,834)
Cash flows from financing activities:
Proceeds from borrowings	2,658,329
Repayments of Debt	(1,495,062)	(2,578)
Purchases of treasury stock	(884,995)	(750,000)
Exercise of stock options	104,004	40,787
Excess tax benefits from stock-based compensation arrangements	4,575	24
Dividends paid	(48,830)	(54,217)
Distributions to noncontrolling interests	(25,765)	(25,568)
Other financing activities	(6,402)	(12,067)
Net cash provided by (used in) financing activities	305,854	(803,619)
Net change in cash and cash equivalents	(338,476)	(164,995)
Cash and cash equivalents, beginning of period	449,301	534,256
Cash and cash equivalents, end of period	$ 110,825	$ 369,261