CONSOLIDATED STATEMENTS OF CASH FLOWS (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2012	Mar. 31, 2011
Cash flows from operating activities:
Net income (loss)	$ 168,515	$ (46,662)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization	72,174	63,365
Provision for doubtful accounts	80,718	77,376
Deferred income tax benefit	(15,437)	(38,766)
Stock-based compensation expense	20,068	18,945
Excess tax benefits from stock-based compensation arrangements	(3,298)	(4,680)
Provision for special charge		236,000
Other, net	(197)	3,474
Changes in operating assets and liabilities:
Accounts receivable	(147,174)	(171,275)
Accounts payable and accrued expenses	(116,209)	(47,126)
Income taxes payable	112,039	78,676
Other assets and liabilities, net	(9,932)	(8,747)
Net cash provided by operating activities	161,267	160,580
Cash flows from investing activities:
Business acquisitions, net of cash acquired	(50,556)
Capital expenditures	(29,998)	(38,991)
Increase in investments and other assets	(2,689)	(1,762)
Net cash used in investing activities	(83,243)	(40,753)
Cash flows from financing activities:
Proceeds from borrowings	365,000	1,818,329
Repayments of debt	(467,312)	(576,891)
Purchases of treasury stock	(50,000)	(835,001)
Exercise of stock options	64,399	53,788
Excess tax benefits from stock-based compensation arrangements	3,298	4,680
Dividends paid	(26,900)	(17,136)
Distributions to noncontrolling interests	(5,884)	(5,268)
Other financing activities	19,928	(17,387)
Net cash (used in) provided by financing activities	(97,471)	425,114
Net change in cash and cash equivalents	(19,447)	544,941
Cash and cash equivalents, beginning of period	164,886	449,301
Cash and cash equivalents, end of period	$ 145,439	$ 994,242