Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Cash flows from operating activities:
Net income	$ 2,693	$ 2,872
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable	930	(93)
Inventories and other assets	(36)	(95)
Accounts payable and accrued expenses	542	(118)
Government stimulus refund liability	6,123
Depreciation and amortization	2,059	1,902
Income taxes	(114)	51
Losses (gains) on sales of facilities	6	(17)
Losses on retirement of debt	295	211
Amortization of debt issuance costs and discounts	22	23
Share-based compensation	229	263
Other	66	98
Net cash provided by operating activities	12,815	5,097
Cash flows from investing activities:
Purchase of property and equipment	(2,087)	(2,884)
Acquisition of hospitals and health care entities	(380)	(1,592)
Sales of hospitals and health care entities	68	49
Change in investments	(40)	35
Other	(44)	17
Net cash used in investing activities	(2,483)	(4,375)
Cash flows from financing activities:
Issuances of long-term debt	2,700	6,451
Net change in revolving bank credit facilities	(2,480)	(30)
Repayment of long-term debt	(3,403)	(5,289)
Distributions to noncontrolling interests	(393)	(404)
Payment of debt issuance costs	(35)	(71)
Payment of dividends	(153)	(414)
Repurchases of common stock	(441)	(759)
Other	(156)	(145)
Net cash used in financing activities	(4,361)	(661)
Effect of exchange rate changes on cash and cash equivalents	(4)	(4)
Change in cash and cash equivalents	5,967	57
Cash and cash equivalents at beginning of period	621	502
Cash and cash equivalents at end of period	6,588	559
Interest payments	1,230	1,492
Income tax payments, net	$ 779	$ 714