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Stock Option Plans and Share-Based Compensation Performance based stock units (PSU) (Details) (USD $) | 3 Months Ended |  |  | 0 Months Ended | 3 Months Ended | 0 Months Ended | 12 Months Ended | 3 Months Ended
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Mar. 31, 2014 | Mar. 31, 2013 | Mar. 31, 2014 Performance Shares [Member] | Mar. 31, 2013 Performance Shares [Member] | Dec. 31, 2013 Performance Shares [Member] | Dec. 31, 2012 Performance Shares [Member] | Mar. 20, 2014 2013 PSU [Member] Performance Shares [Member] | Mar. 31, 2014 2013 PSU [Member] Performance Shares [Member] | Jan. 22, 2013 2012 PSU [Member] Performance Shares [Member] | Dec. 31, 2012 2012 PSU [Member] Performance Shares [Member] | Mar. 31, 2014 Minimum [Member] Below the 75th percentile ranking [Member] PSU program year one [Member] Performance Shares [Member] | Mar. 31, 2014 Maximum [Member] Below the 75th percentile ranking [Member] PSU program year one [Member] Performance Shares [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items] |  |  |  |  |  |  |  |  |  |  |  |
PSU percentage eligible for time-based vesting |  |  |  |  |  |  |  |  |  |  | 110.00% | 119.00%
Employee Service Share-based Compensation, Nonvested Awards, Total Compensation Cost Not yet Recognized, Share-based Awards Other than Options |  |  | $ 2,800,000 |  |  |  |  |  |  |  |  |
Employee Service Share-based Compensation, Nonvested Awards, Total Compensation Cost Not yet Recognized, Period for Recognition |  |  | 1 year 6 months 6 days |  |  |  |  |  |  |  |  |
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number |  |  | 323,000 |  | 225,000 |  |  |  |  |  |  |
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value |  |  | $ 14.41 |  | $ 13.32 |  |  |  |  |  |  |
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period |  |  | 132,000 |  |  |  |  | 132,500 |  | 125,000 |  |
PSU shares eligible for vesting based on actual shareholder return |  |  |  |  |  |  | 137,500 |  | 62,500 |  |  |
Share-based Compensation Arrangement by Share-based Payment Award, First Year Share Vesting Rate |  |  |  |  |  |  | 25.00% |  | 25.00% |  |  |
Share-based Compensation Arrangement By Share-based Payment Award, Number Of Shares Eligible For Vesting |  |  |  |  |  | 62,500 |  |  |  |  |  |
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period |  |  | (34,000) |  |  |  |  |  |  |  |  |
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Grants in Period, Weighted Average Grant Date Fair Value |  |  | $ 16.59 |  |  |  |  |  |  |  |  |
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period, Weighted Average Grant Date Fair Value |  |  | $ 14.81 |  |  |  |  |  |  |  |  |
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Forfeited in Period |  |  | 0 |  |  |  |  |  |  |  |  |
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Forfeitures, Weighted Average Grant Date Fair Value |  |  | $ 0.00 |  |  |  |  |  |  |  |  |
Allocated Share-based Compensation Expense | $ 2,729,000 | $ 2,926,000 | $ 500,000 | $ 400,000 |  |  |  |  |  |  |  |
PSU percentage eligible for vesting based on actual return |  |  |  |  |  |  | 100.00% |  | 50.00% |  |  |

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- Definition PSU percentage eligible for time-based vesting = the percentage of the original PSU award which will continue with service-based vesting based on the percentile ranking against total stock performance in the reference year for the health care index. + References No definition available. + Details
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- Definition PSU percentage eligible for vesting based on actual return = percentage of original PSU awards that continue under service-based vesting, based on percentile performance in the grant year for Total Shareholder Return + References No definition available. + Details
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- Definition PSU shares eligible for vesting based on actual shareholder return = No. of PSU shares that continue with service-based vesting, based on percentile performance of Total shareholder return in the calendar year of grant. + References No definition available. + Details
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- Definition Share-based Compensation Arrangement by Share-based Payment Award, First Year Share Vesting Rate + References No definition available. + Details
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- Definition Represents the expense recognized during the period arising from equity-based compensation arrangements (for example, shares of stock, unit, stock options or other equity instruments) with employees, directors and certain consultants qualifying for treatment as employees. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 1 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5047-113901 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SAB TOPIC 14.F) -URI http://asc.fasb.org/extlink&oid=27013229&loc=d3e301413-122809 Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (h)(1)(i) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5070-113901 Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher SEC -Name Staff Accounting Bulletin (SAB) -Number Topic 14 -Section F + Details
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- Definition Weighted average period over which unrecognized compensation is expected to be recognized for equity-based compensation plans, in 'PnYnMnDTnHnMnS' format, for example, 'P1Y5M13D' represents the reported fact of one year, five months, and thirteen days. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (i) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5070-113901 + Details
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- Definition Unrecognized cost of unvested share-based awards, other than options, awarded to employees as compensation. + References No definition available. + Details
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- Definition The number of equity-based payment instruments, excluding stock (or unit) options, that were forfeited during the reporting period. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (c)(1)(iv)(3) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5070-113901 + Details
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- Definition Weighted average fair value as of the grant date of equity-based award plans other than stock (unit) option plans that were not exercised or put into effect as a result of the occurrence of a terminating event. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (c)(2)(iii)(3) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5070-113901 + Details
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- Definition The number of grants made during the period on other than stock (or unit) option plans (for example, phantom stock or unit plan, stock or unit appreciation rights plan, performance target plan). + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (c)(2)(iii)(1) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5070-113901 + Details
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- Definition The weighted average fair value at grant date for nonvested equity-based awards issued during the period on other than stock (or unit) option plans (for example, phantom stock or unit plan, stock or unit appreciation rights plan, performance target plan). + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (c)(2)(iii)(1) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5070-113901 + Details
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- Definition The number of non-vested equity-based payment instruments, excluding stock (or unit) options, that validly exist and are outstanding as of the balance sheet date. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (c)(2)(i)-(ii) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5070-113901 + Details
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- Definition The weighted average fair value of nonvested awards on equity-based plans excluding option plans (for example, phantom stock or unit plan, stock or unit appreciation rights plan, revenue or profit achievement stock award plan) for which the employer is contingently obligated to issue equity instruments or transfer assets to an employee who has not yet satisfied service or performance criteria necessary to gain title to proceeds from the sale of the award or underlying shares or units. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (c)(2)(i)-(ii) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5070-113901 + Details
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- Definition The number of equity-based payment instruments, excluding stock (or unit) options, that vested during the reporting period. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (c)(2)(iii)(2) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5070-113901 + Details
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- Definition The weighted average fair value as of grant date pertaining to an equity-based award plan other than a stock (or unit) option plan for which the grantee gained the right during the reporting period, by satisfying service and performance requirements, to receive or retain shares or units, other instruments, or cash in accordance with the terms of the arrangement. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 718 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (c)(2)(iii)(2) -URI http://asc.fasb.org/extlink&oid=6415400&loc=d3e5070-113901 + Details
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