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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
 6 Months Ended
Jun. 30, 2025
Jun. 30, 2024
Statement of Cash Flows [Abstract]    
Net income $ 1,144 $ 2,811
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 414 416
Deferred income tax expense (benefit) 11 (93)
Stock-based compensation expense 41 36
Impairment and restructuring charges, and acquisition-related costs 43 56
Litigation and investigation costs 45 9
Net losses (gains) on sales, consolidation and deconsolidation of facilities 16 (2,558)
Loss from early extinguishment of debt 0 8
Equity in earnings of unconsolidated affiliates, net of distributions received (8) (3)
Amortization of debt discount and debt issuance costs 12 14
Net gains from the sale of investments and long-lived assets 0 (1)
Other items, net (1) (3)
Changes in cash from operating assets and liabilities:    
Accounts receivable 40 77
Inventories and other current assets 9 16
Income taxes 10 713
Accounts payable, accrued expenses and other current liabilities 24 (124)
Other long-term liabilities 32 23
Payments for restructuring charges, acquisition-related costs, and litigation costs and settlements (81) (64)
Net cash provided by operating activities 1,751 1,333
Cash flows from investing activities:    
Purchases of property and equipment (366) (385)
Purchases of businesses or joint venture interests, net of cash acquired (147) (510)
Proceeds from sales of facilities and other assets 14 4,048
Proceeds from sales of marketable securities and long-term investments 37 17
Purchases of marketable securities and long-term investments (38) (26)
Other items, net (1) (10)
Net cash provided by (used in) investing activities (501) 3,134
Cash flows from financing activities:    
Repayments of borrowings (62) (2,179)
Proceeds from borrowings 15 8
Repurchases of common stock (1,095) (548)
Distributions paid to noncontrolling interests (374) (323)
Proceeds from the sale of noncontrolling interests 18 10
Purchases of noncontrolling interests (79) (88)
Advances from managed care payers 0 342
Repayments of advances from managed care payers (12) 0
Other items, net (55) (37)
Net cash used in financing activities (1,644) (2,815)
Net increase (decrease) in cash and cash equivalents (394) 1,652
Cash and cash equivalents at beginning of period 3,019 1,228
Cash and cash equivalents at end of period 2,625 2,880
Supplemental disclosures:    
Interest paid, net of capitalized interest (399) (459)
Income tax payments, net $ (242) $ (240)