Consolidated Statements of Cash Flows - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Cash flows from operating activities:
Net income	$ 4,145	$ 4,389	$ 2,743
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable	(326)	(423)	(601)
Inventories and other assets	(158)	(242)	(69)
Accounts payable and accrued expenses	396	698	374
Depreciation and amortization	2,596	2,278	2,131
Income taxes	250	74	433
Gains on sales of facilities	(18)	(428)	(8)
Losses on retirement of debt	211	9	39
Amortization of debt issuance costs	30	31	31
Share-based compensation	347	268	270
Other	129	107	83
Net cash provided by operating activities	7,602	6,761	5,426
Cash flows from investing activities:
Purchase of property and equipment	(4,158)	(3,573)	(3,015)
Acquisition of hospitals and health care entities	(1,682)	(1,253)	(1,212)
Sales of hospitals and health care entities	61	808	25
Change in investments	25	57	(73)
Other	34	60	(4)
Net cash used in investing activities	(5,720)	(3,901)	(4,279)
Cash flows from financing activities:
Issuances of long-term debt	6,451	2,000	1,502
Net change in revolving bank credit facilities	(560)	(640)	760
Repayment of long-term debt	(5,324)	(1,704)	(753)
Distributions to noncontrolling interests	(542)	(441)	(448)
Payment of debt issuance costs	(73)	(25)	(26)
Payment of dividends	(550)	(487)	0
Repurchases of common stock	(1,031)	(1,530)	(2,051)
Other	(142)	(248)	(45)
Net cash used in financing activities	(1,771)	(3,075)	(1,061)
Effect of exchange rate changes on cash and cash equivalents	8	(15)	0
Change in cash and cash equivalents	119	(230)	86
Cash and cash equivalents at beginning of period	502	732	646
Cash and cash equivalents at end of period	621	502	732
Interest payments	1,914	1,744	1,700
Income tax payments, net	$ 849	$ 872	$ 1,205