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Significant Accounting Policies - Variable Interest Entities (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2023
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2014
Variable Interest Entity [Line Items]        
Total assets $ 249,728 $ 228,275    
Total liabilities 173,092 156,506    
Long-term investments 23,019 21,096    
Variable Interest Entity, Primary Beneficiary, Red Oak Sourcing, LLC        
Variable Interest Entity [Line Items]        
VIE, ownership percentage       50.00%
Initial contractual term (in years)       10 years
Amended contract extension term     5 years  
Amended contract term (in years)     15 years  
Proceeds from VIE 183 183 $ 183  
Variable Interest Entity, Primary Beneficiary, Physicians Groups        
Variable Interest Entity [Line Items]        
Total assets 1,515      
Total liabilities 1,503      
Variable Interest Entity, Not Primary Beneficiary        
Variable Interest Entity [Line Items]        
Long-term investments 2,018 1,537    
Variable Interest Entity, Not Primary Beneficiary | Hedge fund investments        
Variable Interest Entity [Line Items]        
Long-term investments 859 589    
Variable Interest Entity, Not Primary Beneficiary | Private equity investments        
Variable Interest Entity [Line Items]        
Long-term investments 840 707    
Variable Interest Entity, Not Primary Beneficiary | Real estate partnerships        
Variable Interest Entity [Line Items]        
Long-term investments $ 319 $ 241