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Segment and Geographic Information - Schedule of Geographic Distributions of Revenues, Equity in Earnings or Losses of Affiliates, Adjusted Segment EBITDA, Depreciation and Amortization (Detail) - USD ($)
$ in Millions
 3 Months Ended 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Sep. 30, 2025
Sep. 30, 2024
Dec. 31, 2024
Segment Reporting Information [Line Items]          
Revenues $ 19,161 $ 17,487 $ 56,087 $ 52,318  
Salaries and benefits 8,364 7,861 24,499 23,253  
Supplies 2,782 2,657 8,390 7,962  
Other operating expenses 4,161 3,717 11,799 10,946  
Equity in (earnings) losses of affiliates (16) (15) (53) (13)  
Depreciation and amortization 889 842 2,612 2,456  
Interest expense 561 515 1,676 1,533  
Losses (gains) on sales of facilities 2 4 4 (209)  
Income before income taxes 2,418 1,906 7,160 6,390  
Assets 59,747   59,747   $ 59,513
Operating Segments [Member]          
Segment Reporting Information [Line Items]          
Adjusted segment EBITDA 4,267 3,567 12,480 10,996  
Eliminations and Reconciling Items [Member]          
Segment Reporting Information [Line Items]          
Corporate and Other 397 300 1,028 826  
Depreciation and amortization 889 842 2,612 2,456  
Interest expense 561 515 1,676 1,533  
Losses (gains) on sales of facilities 2 4 4 (209)  
Income before income taxes 2,418 1,906 7,160 6,390  
National Group [Member] | Operating Segments [Member]          
Segment Reporting Information [Line Items]          
Revenues 5,525 4,931 15,790 14,622  
Salaries and benefits 1,970 1,897 5,848 5,656  
Supplies 742 696 2,238 2,094  
Other operating expenses 1,466 1,270 3,954 3,668  
Equity in (earnings) losses of affiliates (1) 0 (1) 2  
Operating expenses 4,177 3,863 12,039 11,420  
Adjusted segment EBITDA 1,348 1,068 3,751 3,202  
Depreciation and amortization 226 214 675 637  
Assets 13,274   13,274   12,855
Atlantic Group [Member] | Operating Segments [Member]          
Segment Reporting Information [Line Items]          
Revenues 6,142 5,738 18,431 17,429  
Salaries and benefits 2,288 2,190 6,750 6,500  
Supplies 889 858 2,738 2,651  
Other operating expenses 1,627 1,555 4,793 4,581  
Equity in (earnings) losses of affiliates (1) 0 (3) (2)  
Operating expenses 4,803 4,603 14,278 13,730  
Adjusted segment EBITDA 1,339 1,135 4,153 3,699  
Depreciation and amortization 281 271 830 790  
Assets 17,573   17,573   17,168
American Group [Member] | Operating Segments [Member]          
Segment Reporting Information [Line Items]          
Revenues 6,688 6,078 19,512 18,105  
Salaries and benefits 2,275 2,176 6,687 6,405  
Supplies 1,053 1,007 3,140 2,965  
Other operating expenses 1,796 1,549 5,156 4,689  
Equity in (earnings) losses of affiliates (16) (18) (47) (49)  
Operating expenses 5,108 4,714 14,936 14,010  
Adjusted segment EBITDA 1,580 1,364 4,576 4,095  
Depreciation and amortization 283 277 839 799  
Assets 20,889   20,889   20,714
Corporate and Other [Member]          
Segment Reporting Information [Line Items]          
Revenues 806 740 2,354 2,162  
Depreciation and amortization 99 $ 80 268 $ 230  
Assets $ 8,011   $ 8,011   $ 8,776