Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Cash flows from operating activities:
Net income	$ 2,248	$ 1,572
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable	(233)	81
Inventories and other assets	(200)	(178)
Accounts payable and accrued expenses	31	(298)
Depreciation and amortization	1,115	1,042
Income taxes	118	267
Gains on sales of facilities	(414)	(3)
Amortization of debt issuance costs	15	16
Share-based compensation	134	140
Other	51	45
Net cash provided by (used in) operating activities	2,865	2,684
Cash flows from investing activities:
Purchase of property and equipment	(1,574)	(1,304)
Acquisition of hospitals and health care entities	(538)	(295)
Disposal of hospitals and health care entities	799	14
Change in investments	23	(11)
Other	(25)	5
Net cash used in investing activities	(1,315)	(1,591)
Cash flows from financing activities:
Issuances of long-term debt		1,502
Net change in revolving bank credit facilities	210	(1,160)
Repayment of long-term debt	(101)	(95)
Distributions to noncontrolling interests	(185)	(248)
Payment of debt issuance costs	(2)	(25)
Payment of cash dividends	(245)
Repurchases of common stock	(893)	(966)
Other	(192)	(42)
Net cash (used in) provided by financing activities	(1,408)	(1,034)
Effect of exchange rate changes on cash and cash equivalents	(6)
Change in cash and cash equivalents	136	59
Cash and cash equivalents at beginning of period	732	646
Cash and cash equivalents at end of period	868	705
Interest payments	873	834
Income tax payments, net	$ 411	$ 387