Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Cash flows from operating activities:
Net income	$ 698	$ 1,181
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable	464	(369)
Inventories and other assets	(196)	(174)
Accounts payable and accrued expenses	(784)	(651)
Depreciation and amortization	674	619
Income taxes	121	269
Losses (gains) on sales of facilities	(7)	1
Losses on retirement of debt	295	0
Amortization of debt issuance costs and discounts	7	8
Share-based compensation	82	62
Other	21	28
Net cash provided by operating activities	1,375	974
Cash flows from investing activities:
Purchase of property and equipment	(853)	(781)
Acquisition of hospitals and health care entities	(328)	(1,474)
Sales of hospitals and health care entities	35	30
Change in investments	(1)	36
Other	2	24
Net cash used in investing activities	(1,145)	(2,165)
Cash flows from financing activities:
Issuances of long-term debt	2,700	1,500
Net change in revolving bank credit facilities	1,440	460
Repayment of long-term debt	(3,327)	(49)
Distributions to noncontrolling interests	(154)	(136)
Payment of debt issuance costs	(34)	(22)
Payment of dividends	(152)	(141)
Repurchases of common stock	(441)	(278)
Other	(141)	(118)
Net cash (used in) provided by financing activities	(109)	1,216
Effect of exchange rate changes on cash and cash equivalents	(11)	4
Change in cash and cash equivalents	110	29
Cash and cash equivalents at beginning of period	621	502
Cash and cash equivalents at end of period	731	531
Interest payments	468	580
Income tax (refunds) payments, net	$ (9)	$ 10