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Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Cash flows from operating activities:    
Net income $ 5,619 $ 4,971
Increase (decrease) in cash from operating assets and liabilities:    
Accounts receivable 345 55
Inventories and other assets (125) 184
Accounts payable and accrued expenses 29 77
Depreciation and amortization 2,612 2,456
Income taxes 1,314 (67)
Losses (gains) on sales of facilities 4 (209)
Amortization of debt issuance costs and discounts 32 26
Share-based compensation 301 275
Other 146 187
Net cash provided by operating activities 10,277 7,955
Cash flows from investing activities:    
Purchase of property and equipment (3,455) (3,590)
Acquisition of hospitals and health care entities (361) (224)
Sales of hospitals and health care entities 177 312
Change in investments (26) (85)
Other (6) 0
Net cash used in investing activities (3,671) (3,587)
Cash flows from financing activities:    
Issuance of long-term debt 5,233 7,495
Net change in short-term borrowings and revolving credit facilities 1,906 (1,880)
Repayment of long-term debt (5,834) (2,346)
Distributions to noncontrolling interests (631) (530)
Payment of debt issuance costs (57) (67)
Payment of dividends (517) (525)
Repurchase of common stock (7,509) (4,342)
Other (142) (224)
Net cash used in financing activities (7,551) (2,419)
Effect of exchange rate changes on cash and cash equivalents 9 4
Change in cash and cash equivalents (936) 1,953
Cash and cash equivalents at beginning of period 1,933 935
Cash and cash equivalents at end of period 997 2,888
Interest payments 1,696 1,405
Income tax payments, net $ 227 $ 1,486