Consolidated Statements of Cash Flows - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Cash flows from operating activities:
Net income	$ 7,721	$ 4,387	$ 4,145
Increase (decrease) in cash from operating assets and liabilities:
Accounts receivable	(962)	327	(326)
Inventories and other assets	(540)	(304)	(158)
Accounts payable and accrued expenses	999	1,255	396
Depreciation and amortization	2,853	2,721	2,596
Income taxes	(70)	41	250
Losses (gains) on sales of facilities	(1,620)	7	(18)
Losses on retirement of debt	12	295	211
Amortization of debt issuance costs	27	30	30
Share-based compensation	440	362	347
Other	99	111	129
Net cash provided by operating activities	8,959	9,232	7,602
Cash flows from investing activities:
Purchase of property and equipment	(3,577)	(2,835)	(4,158)
Acquisition of hospitals and health care entities	(1,105)	(568)	(1,682)
Sales of hospitals and health care entities	2,160	68	61
Change in investments	(117)	(20)	25
Other	(4)	(38)	34
Net cash used in investing activities	(2,643)	(3,393)	(5,720)
Cash flows from financing activities:
Issuances of long-term debt	4,344	2,700	6,451
Net change in revolving credit facilities	2,780	(2,480)	(560)
Repayment of long-term debt	(3,869)	(3,437)	(5,324)
Distributions to noncontrolling interests	(749)	(626)	(542)
Payment of debt issuance costs	(38)	(35)	(73)
Payment of dividends	(624)	(153)	(550)
Repurchase of common stock	(8,215)	(441)	(1,031)
Other	(284)	(205)	(142)
Net cash used in financing activities	(6,655)	(4,677)	(1,771)
Effect of exchange rate changes on cash and cash equivalents	(3)	10	8
Change in cash and cash equivalents	(342)	1,172	119
Cash and cash equivalents at beginning of period	1,793	621	502
Cash and cash equivalents at end of period	1,451	1,793	621
Interest payments	1,502	1,607	1,914
Income tax payments, net	$ 2,182	$ 1,002	$ 849