Consolidated Statements of Cash Flows - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash flows from operating activities:
Net income	$ 6,091	$ 6,834	$ 7,721
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable	(935)	(797)	(962)
Inventories and other assets	(126)	(59)	(540)
Accounts payable and accrued expenses	604	(296)	999
Depreciation and amortization	3,077	2,969	2,853
Income taxes	229	571	(70)
Losses (gains) on sales of facilities	5	(1,301)	(1,620)
Losses on retirement of debt	0	78	12
Amortization of debt issuance costs and discounts	35	29	27
Share-based compensation	262	341	440
Other	189	153	99
Net cash provided by operating activities	9,431	8,522	8,959
Cash flows from investing activities:
Purchase of property and equipment	(4,744)	(4,395)	(3,577)
Acquisition of hospitals and health care entities	(635)	(224)	(1,105)
Sales of hospitals and health care entities	193	1,237	2,160
Change in investments	(112)	14	(117)
Other	(19)	(21)	(4)
Net cash used in investing activities	(5,317)	(3,389)	(2,643)
Cash flows from financing activities:
Issuances of long-term debt	3,224	5,997	4,344
Net change in revolving credit facilities	(1,020)	120	2,780
Repayment of long-term debt	(909)	(2,830)	(3,869)
Distributions to noncontrolling interests	(640)	(1,025)	(749)
Payment of debt issuance costs	(31)	(53)	(38)
Payment of dividends	(661)	(653)	(624)
Repurchase of common stock	(3,811)	(7,000)	(8,215)
Other	(246)	(212)	(284)
Net cash used in financing activities	(4,094)	(5,656)	(6,655)
Effect of exchange rate changes on cash and cash equivalents	7	(20)	(3)
Change in cash and cash equivalents	27	(543)	(342)
Cash and cash equivalents at beginning of period	908	1,451	1,793
Cash and cash equivalents at end of period	935	908	1,451
Interest payments	1,892	1,662	1,502
Income tax payments, net	$ 1,386	$ 1,175	$ 2,182