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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 | 12 Months Ended
--- | ---
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019
Segment Reporting Information [Line Items] |  |  |
Revenues | $ 58,752 | $ 51,533 | $ 51,336
Equity in earnings of affiliates | (113) | (54) | (43)
Adjusted segment EBITDA | 12,644 | 10,037 | 9,857
Depreciation and amortization | 2,853 | 2,721 | 2,596
Interest expense | 1,566 | 1,584 | 1,824
Losses (gains) on sales of facilities | (1,620) | 7 | (18)
Losses on retirement of debt | 12 | 295 | 211
Income before income taxes | 9,833 | 5,430 | 5,244
Assets | 50,742 | 47,490 | 45,058
Goodwill and other intangible assets, Beginning Balance | 8,578 | 8,269 | 7,953
Goodwill and other intangible assets, Acquisitions | 1,062 | 344 | 332
Goodwill and other intangible assets, Foreign currency translation, amortization and other | (100) | (35) | (16)
Goodwill and other intangible assets, Ending Balance | 9,540 | 8,578 | 8,269
National Group [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Revenues | 29,826 | 25,694 | 25,913
Equity in earnings of affiliates | (33) | (28) | (2)
Adjusted segment EBITDA | 7,200 | 5,532 | 5,634
Depreciation and amortization | 1,359 | 1,216 | 1,161
Assets | 21,205 | 18,913 | 18,290
Goodwill and other intangible assets, Beginning Balance | 1,775 | 1,739 | 1,597
Goodwill and other intangible assets, Acquisitions | 735 | 38 | 155
Goodwill and other intangible assets, Foreign currency translation, amortization and other | (18) | (2) | (13)
Goodwill and other intangible assets, Ending Balance | 2,492 | 1,775 | 1,739
American Group [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Revenues | 26,152 | 23,593 | 23,173
Equity in earnings of affiliates | (53) | (42) | (44)
Adjusted segment EBITDA | 6,156 | 5,333 | 4,904
Depreciation and amortization | 1,183 | 1,164 | 1,117
Assets | 21,428 | 20,760 | 20,608
Goodwill and other intangible assets, Beginning Balance | 5,775 | 5,765 | 5,729
Goodwill and other intangible assets, Acquisitions | 67 | 27 | 39
Goodwill and other intangible assets, Foreign currency translation, amortization and other | (10) | (17) | (3)
Goodwill and other intangible assets, Ending Balance | 5,832 | 5,775 | 5,765
Corporate and Other [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Revenues | 2,774 | 2,246 | 2,250
Equity in earnings of affiliates | (27) | 16 | 3
Adjusted segment EBITDA | (712) | (828) | (681)
Depreciation and amortization | 311 | 341 | 318
Assets | 8,109 | 7,817 | 6,160
Goodwill and other intangible assets, Beginning Balance | 1,028 | 765 | 627
Goodwill and other intangible assets, Acquisitions | 260 | 279 | 138
Goodwill and other intangible assets, Foreign currency translation, amortization and other | (72) | (16) |
Goodwill and other intangible assets, Ending Balance | $ 1,216 | $ 1,028 | $ 765

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