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Valuation and Qualifying Accounts (Details) - Allowance for doubtful accounts - USD ($)
$ in Thousands
12 Months Ended
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
Activity in Valuation and Qualifying Accounts      
Balance at Beginning of Year $ 17,440 $ 21,769 $ 25,414
Charged to Cost and Expenses 124,143 149,599 94,186
Deductions (126,527) (153,928) (97,831)
Balance at End of Year $ 15,056 $ 17,440 $ 21,769