Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2017	Sep. 30, 2016
Cash flows from operating activities:
Net income	$ 167,767	$ 65,050
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	622,135	534,026
Stock-based compensation	129,602	115,730
Amortization of intangible assets	128,068	93,384
Amortization of debt issuance costs and debt discounts	20,100	13,709
Provision for allowance for doubtful accounts	6,889	6,541
Impairment charges	0	7,698
Gain on asset sales	0	(33,187)
Gain on sale of discontinued operations	0	(4,242)
Loss on debt extinguishment	42,103	10,499
Other items	3,437	14,843
Changes in operating assets and liabilities:
Accounts receivable	(202,430)	(72,807)
Income taxes, net	(53,608)	1,021
Accounts payable and accrued expenses	44,952	(11,526)
Other assets and liabilities	35,339	(22,004)
Net cash provided by operating activities	944,354	718,735
Cash flows from investing activities:
Purchases of investments	(57,926)	(31,736)
Sales and maturities of investments	32,867	41,796
Business acquisitions, net of cash and restricted cash acquired	(3,628,526)	(1,767,227)
Purchases of real estate	(64,964)	(28,118)
Purchases of other property, plant and equipment	(946,048)	(727,044)
Proceeds from sale of assets	47,767	828,197
Net cash used in investing activities	(4,616,830)	(1,684,132)
Cash flows from financing activities:
Proceeds from employee equity awards	41,625	34,143
Payment of dividends	(463,914)	(374,151)
Proceeds from public offering of common stock, net of offering costs	2,126,341	0
Proceeds from senior notes	2,449,700	0
Proceeds from loans payable	1,059,800	710,404
Repayments of capital lease and other financing obligations	(60,252)	(100,863)
Repayments of convertible debt, mortgage, and loans payable	(63,520)	(986,465)
Repayment of senior notes	(500,000)	0
Debt extinguishment costs	(23,020)	(10,181)
Debt issuance costs	(56,886)	(11,751)
Other financing activities	(900)	0
Net cash provided by (used) in financing activities	4,508,974	(738,864)
Effect of foreign currency exchange rates on cash, cash equivalents and restricted cash	26,450	13,130
Change in cash balances included in assets held for sale	0	(3,755)
Net increase (decrease) in cash, cash equivalents and restricted cash	862,948	(1,694,886)
Cash, cash equivalents and restricted cash at beginning of period	773,247	2,718,427
Cash, cash equivalents and restricted cash at end of period	1,636,195	1,023,541
Cash and cash equivalents	1,599,988	987,915
Current portion of restricted cash included in other current assets	25,079	25,305
Non-current portion of restricted cash included in other assets	$ 11,128	$ 10,321