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Income tax provision (Details) (USD $)
In Thousands, unless otherwise specified
9 Months Ended
Sep. 30, 2011
Sep. 30, 2010
Income tax provision [Abstract]  
Effective tax rate (in hundredths)32.00%35.00%
Favorably (unfavorable) impact on effective tax rate, Medicare Part D subsidies (in hundredths)1.00%(1.70%)
Favorably (unfavorably) impact on effective tax rate, other items (in hundredths)1.20% 
Charge resulting from the Health Care and Education Reconciliation Act of 2010 $ 4,063
Favorable impact on effective tax rate, uncertain tax positions (in hundredths) 1.30%