Consolidated Statements of Cash Flows - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2024	Dec. 31, 2023	Dec. 31, 2022
Cash flows from operating activities:
Net income	$ 6,657	$ 6,091	$ 6,834
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable	(799)	(935)	(797)
Inventories and other assets	334	(126)	(59)
Accounts payable and accrued expenses	359	604	(296)
Depreciation and amortization	3,312	3,077	2,969
Income taxes	22	229	571
Losses (gains) on sales of facilities	(14)	5	(1,301)
Losses on retirement of debt	0	0	78
Amortization of debt issuance costs and discounts	35	35	29
Share-based compensation	360	262	341
Other	248	189	153
Net cash provided by operating activities	10,514	9,431	8,522
Cash flows from investing activities:
Purchase of property and equipment	(4,875)	(4,744)	(4,395)
Acquisition of hospitals and health care entities	(266)	(635)	(224)
Sales of hospitals and health care entities	328	193	1,237
Change in investments	(115)	(112)	14
Other	(5)	(19)	(21)
Net cash used in investing activities	(4,933)	(5,317)	(3,389)
Cash flows from financing activities:
Issuances of long-term debt	7,495	3,224	5,997
Net change in revolving credit facilities	(1,880)	(1,020)	120
Repayment of long-term debt	(2,410)	(909)	(2,830)
Distributions to noncontrolling interests	(711)	(640)	(1,025)
Payment of debt issuance costs	(67)	(31)	(53)
Payment of dividends	(690)	(661)	(653)
Repurchase of common stock	(6,042)	(3,811)	(7,000)
Other	(277)	(246)	(212)
Net cash used in financing activities	(4,582)	(4,094)	(5,656)
Effect of exchange rate changes on cash and cash equivalents	(1)	7	(20)
Change in cash and cash equivalents	998	27	(543)
Cash and cash equivalents at beginning of period	935	908	1,451
Cash and cash equivalents at end of period	1,933	935	908
Interest payments	1,938	1,892	1,662
Income tax payments, net	$ 1,844	$ 1,386	$ 1,175