Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Cash flows from operating activities:
Net income	$ 5,716	$ 2,693
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable	(1,312)	930
Inventories and other assets	(333)	(36)
Accounts payable and accrued expenses	731	542
Contract liabilities-deferred revenues	0	6,123
Depreciation and amortization	2,125	2,059
Income taxes	185	(114)
Losses (gains) on sales of facilities	(1,057)	6
Losses on retirement of debt	12	295
Amortization of debt issuance costs and discounts	21	22
Share-based compensation	341	229
Other	87	66
Net cash provided by operating activities	6,516	12,815
Cash flows from investing activities:
Purchase of property and equipment	(2,385)	(2,087)
Acquisition of hospitals and health care entities	(488)	(380)
Sales of hospitals and health care entities	1,980	68
Change in investments	(38)	(40)
Other	2	(44)
Net cash used in investing activities	(929)	(2,483)
Cash flows from financing activities:
Issuances of long-term debt	4,337	2,700
Net change in revolving credit facilities	500	(2,480)
Repayment of long-term debt	(3,787)	(3,403)
Distributions to noncontrolling interests	(501)	(393)
Payment of debt issuance costs	(38)	(35)
Payment of dividends	(476)	(153)
Repurchase of common stock	(6,143)	(441)
Other	(241)	(156)
Net cash used in financing activities	(6,349)	(4,361)
Effect of exchange rate changes on cash and cash equivalents	(4)	(4)
Change in cash and cash equivalents	(766)	5,967
Cash and cash equivalents at beginning of period	1,793	621
Cash and cash equivalents at end of period	1,027	6,588
Interest payments	1,127	1,230
Income tax payments, net	$ 1,346	$ 779