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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		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Segment Reporting Information [Line Items]
Revenues	$ 12,602	$ 11,529	$ 25,119	$ 22,952
Equity in earnings of affiliates	(8)	(7)	(19)	(16)
Adjusted segment EBITDA	2,293	2,227	4,834	4,345
Depreciation and amortization	636	562	1,255	1,115
Interest expense	477	436	938	867
Gains on sales of facilities	(18)	(9)	(17)	(414)
Income before income taxes	1,198	1,238	2,658	2,777
National Group [Member]
Segment Reporting Information [Line Items]
Revenues	6,444	5,609	12,761	11,177
Equity in earnings of affiliates	(3)	(2)	(5)	(4)
Adjusted segment EBITDA	1,364	1,284	2,818	2,466
Depreciation and amortization	283	232	548	457
American Group [Member]
Segment Reporting Information [Line Items]
Revenues	5,626	5,390	11,221	10,717
Equity in earnings of affiliates	(11)	(10)	(22)	(19)
Adjusted segment EBITDA	1,117	1,147	2,258	2,178
Depreciation and amortization	270	255	551	507
Corporate and Other [Member]
Segment Reporting Information [Line Items]
Revenues	532	530	1,137	1,058
Equity in earnings of affiliates	6	5	8	7
Adjusted segment EBITDA	(188)	(204)	(242)	(299)
Depreciation and amortization	$ 83	$ 75	$ 156	$ 151

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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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