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Segment and Geographic Information - Schedule of Geographic Distributions of Revenues, Equity in Earnings of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization and Assets (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2019	Mar. 31, 2018
Segment Reporting Information [Line Items]
Revenues	$ 12,517	$ 11,423
Equity in earnings of affiliates	(11)	(9)
Adjusted segment EBITDA	2,541	2,118
Depreciation and amortization	619	553
Interest expense	461	431
Gains on sales of facilities	1	(405)
Income before income taxes	1,460	1,539
National Group [Member]
Segment Reporting Information [Line Items]
Revenues	6,317	5,568
Equity in earnings of affiliates	(2)	(2)
Adjusted segment EBITDA	1,454	1,182
Depreciation and amortization	265	225
American Group [Member]
Segment Reporting Information [Line Items]
Revenues	5,595	5,327
Equity in earnings of affiliates	(11)	(9)
Adjusted segment EBITDA	1,141	1,031
Depreciation and amortization	281	252
Corporate and Other [Member]
Segment Reporting Information [Line Items]
Revenues	605	528
Equity in earnings of affiliates	2	2
Adjusted segment EBITDA	(54)	(95)
Depreciation and amortization	$ 73	$ 76

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Income before depreciation and amortization, interest expense, losses (gains) on sales of facilities, losses on retirement of debt, legal claim costs, income taxes and net income attributable to non controlling interests.

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