Exhibit 12.1

HCA Healthcare, Inc.    

Ratio of Earnings to Fixed Charges    

(Dollars in millions)    

	Six Months Ended June 30,				Year Ended December 31,
	2018		2017		2017		2016		2015		2014		2013
Earnings:
Income before income taxes	$	2,777	$	2,226	$	4,381	$	4,810	$	3,957	$	3,481	$	2,946
Fixed Charges, exclusive of capitalized interest		994		946		1,931		1,933		1,882		1,937		2,032
	$	3,771	$	3,172	$	6,312	$	6,743	$	5,839	$	5,418	$	4,978
Fixed Charges:
Interest charged to expense	$	867	$	830	$	1,690	$	1,707	$	1,665	$	1,743	$	1,848
Interest factor on rental expense		127		116		241		226		217		194		184
		994		946		1,931		1,933		1,882		1,937		2,032
Interest capitalized		21		19		36		37		30		25		30
	$	1,015	$	965	$	1,967	$	1,970	$	1,912	$	1,962	$	2,062
Ratio of earnings to fixed charges		3.71		3.29		3.21		3.42		3.05		2.76		2.41