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Basis of Presentation and Significant Accounting Policies - Schedule of Revenues from Third Party Payers, Uninsured and Other Payers (Detail) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2019
Mar. 31, 2018
Revenues From Third Party Payers [Line Items]    
Revenues from third party payers $ 12,517 $ 11,423
Revenues ratio from third party payers 100.00% 100.00%
Medicare [Member]    
Revenues From Third Party Payers [Line Items]    
Revenues from third party payers $ 2,770 $ 2,524
Revenues from third party payers, Ratio 22.10% 22.10%
Managed Medicare [Member]    
Revenues From Third Party Payers [Line Items]    
Revenues from third party payers $ 1,589 $ 1,399
Revenues from third party payers, Ratio 12.70% 12.30%
Medicaid [Member]    
Revenues From Third Party Payers [Line Items]    
Revenues from third party payers $ 347 $ 281
Revenues from third party payers, Ratio 2.80% 2.50%
Managed Medicaid [Member]    
Revenues From Third Party Payers [Line Items]    
Revenues from third party payers $ 613 $ 561
Revenues from third party payers, Ratio 4.90% 4.90%
Managed Care and Other Insurers [Member]    
Revenues From Third Party Payers [Line Items]    
Revenues from third party payers $ 6,426 $ 6,062
Revenues from third party payers, Ratio 51.40% 53.10%
International (Managed Care and Other Insurers) [Member]    
Revenues From Third Party Payers [Line Items]    
Revenues from third party payers $ 297 $ 305
Revenues from third party payers, Ratio 2.40% 2.70%
Product and Service, Other [Member]    
Revenues From Third Party Payers [Line Items]    
Revenues from third party payers $ 475 $ 291
Other, Ratio 3.70% 2.40%