Consolidated Statements of Cash Flows - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Cash flows from operating activities:
Net income	$ 4,387	$ 4,145	$ 4,389
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable	327	(326)	(423)
Inventories and other assets	(304)	(158)	(242)
Accounts payable and accrued expenses	1,255	396	698
Depreciation and amortization	2,721	2,596	2,278
Income taxes	41	250	74
Losses (gains) on sales of facilities	7	(18)	(428)
Losses on retirement of debt	295	211	9
Amortization of debt issuance costs	30	30	31
Share-based compensation	362	347	268
Other	111	129	107
Net cash provided by operating activities	9,232	7,602	6,761
Cash flows from investing activities:
Purchase of property and equipment	(2,835)	(4,158)	(3,573)
Acquisition of hospitals and health care entities	(568)	(1,682)	(1,253)
Sales of hospitals and health care entities	68	61	808
Change in investments	(20)	25	57
Other	(38)	34	60
Net cash used in investing activities	(3,393)	(5,720)	(3,901)
Cash flows from financing activities:
Issuances of long-term debt	2,700	6,451	2,000
Net change in revolving credit facilities	(2,480)	(560)	(640)
Repayment of long-term debt	(3,437)	(5,324)	(1,704)
Distributions to noncontrolling interests	(626)	(542)	(441)
Payment of debt issuance costs	(35)	(73)	(25)
Payment of dividends	(153)	(550)	(487)
Repurchase of common stock	(441)	(1,031)	(1,530)
Other	(205)	(142)	(248)
Net cash used in financing activities	(4,677)	(1,771)	(3,075)
Effect of exchange rate changes on cash and cash equivalents	10	8	(15)
Change in cash and cash equivalents	1,172	119	(230)
Cash and cash equivalents at beginning of period	621	502	732
Cash and cash equivalents at end of period	1,793	621	502
Interest payments	1,607	1,914	1,744
Income tax payments, net	$ 1,002	$ 849	$ 872