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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 9 Months Ended
Sep. 30, 2019
Sep. 30, 2018
Sep. 30, 2019
Sep. 30, 2018
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 12,694 $ 11,451 $ 37,813 $ 34,403
Revenues ratio from third party payers 100.00% 100.00% 100.00% 100.00%
Medicare [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 2,592 $ 2,404 $ 7,997 $ 7,353
Revenues from third party payers, Ratio 20.40% 21.00% 21.20% 21.40%
Managed Medicare [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 1,615 $ 1,344 $ 4,799 $ 4,088
Revenues from third party payers, Ratio 12.70% 11.70% 12.70% 11.90%
Medicaid [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 361 $ 338 $ 1,124 $ 976
Revenues from third party payers, Ratio 2.80% 3.00% 3.00% 2.80%
Managed Medicaid [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 641 $ 622 $ 1,808 $ 1,769
Revenues from third party payers, Ratio 5.00% 5.40% 4.80% 5.10%
Managed Care and Other Insurers [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 6,554 $ 6,026 $ 19,405 $ 18,081
Revenues from third party payers, Ratio 51.70% 52.60% 51.10% 52.60%
International (Managed Care and Other Insurers) [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 282 $ 273 $ 863 $ 873
Revenues from third party payers, Ratio 2.20% 2.40% 2.30% 2.50%
Product and Service, Other [Member]        
Revenues From Third Party Payers [Line Items]        
Revenues from third party payers $ 649 $ 444 $ 1,817 $ 1,263
Other, Ratio 5.20% 3.90% 4.90% 3.70%