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CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($)
$ in Thousands
 6 Months Ended
Jun. 30, 2017
Jun. 30, 2016
Cash flows from operating activities:    
Net income $ 661,910 $ 232,662
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 390,244 349,736
Goodwill and asset impairment charges 100,483 253,000
Stock-based compensation expense 17,504 23,717
Deferred income taxes 40,938 19,952
Equity investment income, net 9,367 14,275
Gain (Loss) on Disposition of Business (6,273) (29,791)
Other non-cash charges 28,615 23,120
Changes in operating assets and liabilities, other than from acquisitions and divestitures:    
Accounts receivable (113,208) (104,005)
Inventories (31,067) (9,213)
Other receivables and other current assets (112,469) (107,610)
Other long-term assets (12,124) (431)
Accounts payable (55,897) 22,809
Accrued compensation and benefits (63,727) 41,098
Other current liabilities 13,991 112,825
Income taxes 123,637 135,026
Other long-term liabilities 19,520 (31,531)
Net cash provided by (used in) operating activities 1,011,444 945,639
Cash flows from investing activities:    
Additions of property and equipment (398,940) (358,627)
Acquisitions (619,839) (473,314)
Proceeds from asset and business sales 70,236 17,393
Purchase of investments available for sale (6,812) (7,873)
Purchase of investments held-to-maturity (220,632) (518,965)
Proceeds from sale of investments available for sale 5,049 5,337
Proceeds from investments held-to-maturity 320,484 545,685
Purchase of equity investments (1,194) (8,785)
Proceeds from Sale of Equity Method Investments 0 40,920
Net cash used in investing activities (851,648) (758,229)
Cash flows from financing activities:    
Borrowings 25,529,555 26,134,952
Payments on long-term debt and other financing costs (25,593,587) (26,196,373)
Purchase of treasury stock (231,674) (274,926)
Distributions to noncontrolling interests (116,075) (94,153)
Stock award exercises and other share issuances, net 8,163 9,465
Contributions from noncontrolling interests 39,872 13,117
Purchase of noncontrolling interests (1,432) (6,240)
Other items 0 10,604
Net cash (used in) provided by financing activities (365,178) (403,554)
Effect of exchange rate changes on cash and cash equivalents 4,192 444
Net (decrease) increase in cash (201,190) (215,700)
Cash and cash equivalents at beginning of period 913,187 1,499,116
Cash and cash equivalents at end of period $ 711,997 $ 1,283,416