Income Taxes Schedule of Difference Between Provision For Income Taxes and Federal Statutory Income Tax Rate to Income Before Provision for Income Taxes (Details) (USD $) In Thousands, unless otherwise specified	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Components of Income Tax Expense (Benefit), Continuing Operations [Abstract]
Income Before Provision for Income Taxes	$ 4,208,219	$ 3,611,980	$ 3,651,004
Income Tax Reconciliation, Income Tax Expense (Benefit), at Federal Statutory Income Tax Rate	1,472,877	1,264,193	1,277,852
Income Tax Reconciliation, State Taxes, net of federal benefit	22,164	16,551	27,894
Income Tax Reconciliation, Foreign earnings at different rates	(279,288)	(307,281)	(443,879)
Income Tax Reconciliation, Research and Other Credits	(126,446)	(16,126)	(32,403)
Income Tax Reconciliation, Net Unbenefitted Stock Compensation	24,676	11,292	14,860
Income Tax Reconciliation, Nondeductible pharmaceutical excise tax	33,482	25,809	13,874
Income Tax Reconciliation, Other	3,468	43,943	3,747
Provision for Income Taxes	$ 1,150,933	$ 1,038,381	$ 861,945