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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2025
Sep. 30, 2024
Statement of Cash Flows [Abstract]    
Net income $ 1,723 $ 3,492
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 632 625
Deferred income tax expense (benefit) 51 (29)
Stock-based compensation expense 79 52
Impairment and restructuring charges, and acquisition-related costs 66 75
Litigation and investigation costs 34 18
Net gains on sales, consolidation and deconsolidation of facilities (4) (2,906)
Loss from early extinguishment of debt 0 8
Equity in earnings of unconsolidated affiliates, net of distributions received (13) (9)
Amortization of debt discount and debt issuance costs 18 21
Net gains from the sale of investments and long-lived assets (2) (2)
Other items, net (3) (3)
Changes in cash from operating assets and liabilities:    
Accounts receivable 68 183
Inventories and other current assets (58) 10
Income taxes 15 821
Accounts payable, accrued expenses and other current liabilities 237 123
Other long-term liabilities 50 18
Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements (84) (119)
Net cash provided by operating activities 2,809 2,378
Cash flows from investing activities:    
Purchases of property and equipment (646) (601)
Purchases of businesses or joint venture interests, net of cash acquired (266) (524)
Proceeds from sales of facilities and other assets 18 4,965
Proceeds from sales of marketable securities and long-term investments 74 25
Purchases of marketable securities and long-term investments (69) (46)
Other items, net 3 (18)
Net cash provided by (used in) investing activities (886) 3,801
Cash flows from financing activities:    
Repayments of borrowings (90) (2,212)
Proceeds from borrowings 21 16
Repurchases of common stock (1,188) (672)
Distributions paid to noncontrolling interests (585) (496)
Proceeds from the sale of noncontrolling interests 27 13
Purchases of noncontrolling interests (88) (127)
Advances from managed care payers 0 342
Repayments of advances from managed care payers (33) (160)
Taxes paid related to net share settlement, net of proceeds from shares issued under stock-based compensation plans (47) (14)
Other items, net 16 (3)
Net cash used in financing activities (1,967) (3,313)
Net increase (decrease) in cash and cash equivalents (44) 2,866
Cash and cash equivalents at beginning of period 3,019 1,228
Cash and cash equivalents at end of period 2,975 4,094
Supplemental disclosures:    
Interest paid, net of capitalized interest (499) (555)
Income tax payments, net $ (329) $ (308)