Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Cash flows from operating activities:
Net income	$ 4,971	$ 4,230
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable	55	(168)
Inventories and other assets	184	(274)
Accounts payable and accrued expenses	77	211
Depreciation and amortization	2,456	2,288
Income taxes	(67)	61
Losses (gains) on sales of facilities	(209)	12
Amortization of debt issuance costs and discounts	26	26
Share-based compensation	275	205
Other	187	166
Net cash provided by operating activities	7,955	6,757
Cash flows from investing activities:
Purchase of property and equipment	(3,590)	(3,585)
Acquisition of hospitals and health care entities	(224)	(281)
Sales of hospitals and health care entities	312	183
Change in investments	(85)	(30)
Other	0	(7)
Net cash used in investing activities	(3,587)	(3,720)
Cash flows from financing activities:
Issuance of long-term debt	7,495	3,220
Net change in revolving credit facilities	(1,880)	(1,420)
Repayment of long-term debt	(2,346)	(691)
Distributions to noncontrolling interests	(530)	(497)
Payment of debt issuance costs	(67)	(31)
Payment of dividends	(525)	(501)
Repurchase of common stock	(4,342)	(2,901)
Other	(224)	(234)
Net cash used in financing activities	(2,419)	(3,055)
Effect of exchange rate changes on cash and cash equivalents	4	1
Change in cash and cash equivalents	1,953	(17)
Cash and cash equivalents at beginning of period	935	908
Cash and cash equivalents at end of period	2,888	891
Interest payments	1,405	1,460
Income tax payments, net	$ 1,486	$ 1,070