| Patient Care Costs | $14.8B | $15.1B | $15.4B | $15.5B | $15.6B | $16.2B | $16.3B | $16.2B |
| Uncompensated Care | $10.6B | $11.0B | $11.7B | $11.0B | $11.6B | $12.0B | $13.3B | $13.6B |
| Charity Care | $4.1B | $4.0B | $3.9B | $3.6B | $4.1B | $4.1B | $4.6B | $5.5B |
| Supplies Expense | $2.6B | $2.7B | $2.8B | $2.8B | $2.8B | $2.8B | $3.0B | $2.9B |
| Cash Provided by (Used in) Operating Activity, Including Discontinued Operation | $2.0B | $3.5B | $2.6B | $1.7B | $4.2B | $4.4B | $2.4B | $2.0B |
| Comprehensive Income Including Noncontrolling Interest | $1.7B | $1.5B | $1.7B | $1.9B | $1.9B | $1.9B | $2.2B | $1.8B |
| Comprehensive Income Attributable to Parent | $1.7B | $1.5B | $1.7B | $1.9B | $1.9B | $1.9B | $2.2B | $1.8B |
| Comprehensive Income Including Noncontrolling Interest | $1.7B | $1.5B | $1.7B | $1.9B | $1.9B | $1.9B | $2.2B | $1.8B |
| Comprehensive income (loss), including noncontrolling interest | $1.7B | $1.5B | $1.7B | $1.9B | $1.9B | $1.9B | $2.2B | $1.8B |
| Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest | $1.7B | $1.5B | $1.7B | $1.9B | $1.9B | $1.9B | $2.2B | $1.8B |
| Profit Loss And Other Comprehensive Income | $1.7B | $1.5B | $1.7B | $1.9B | $1.9B | $1.9B | $2.2B | $1.8B |
| Comprehensive Income (Loss), Total | $1.7B | $1.5B | $1.7B | $1.9B | $1.9B | $1.9B | $2.2B | $1.8B |
| Comprehensive Income, Including Noncontrolling Interest | $1.7B | $1.5B | $1.7B | $1.9B | $1.9B | $1.9B | $2.2B | $1.8B |
| Comprehensive Income Including Noncontrolling Interest | $1.7B | $1.5B | $1.7B | $1.9B | $1.9B | $1.9B | $2.2B | $1.8B |
| Total Comprehensive Income | $1.7B | $1.5B | $1.7B | $1.9B | $1.9B | $1.9B | $2.2B | $1.8B |
| Comprehensive Income (Loss), Net of Tax, Attributable to Parent | $1.5B | $1.3B | $1.4B | $1.6B | $1.7B | $1.6B | $1.9B | $1.6B |
| Other Comprehensive Income (Loss) | $1.5B | $1.3B | $1.4B | $1.6B | $1.7B | $1.6B | $1.9B | $1.6B |
| Value of shares repurchased | $1.4B | $1.8B | $1.7B | $2.5B | $2.5B | $2.5B | $2.5B | $1.6B |
| Payments for Repurchase of Common Stock | $1.4B | $1.8B | $1.7B | $2.5B | $2.5B | $2.5B | $2.6B | $1.6B |
| Proceeds From Repayments Of Lines Of Credit | — | -$850.0M | — | $220.0M | $1.5B | $138.0M | $296.0M | $1.4B |
| Cash Provided by (Used in) Investing Activity, Including Discontinued Operation | -$1.3B | -$1.4B | -$1.3B | -$1.0B | -$1.3B | -$1.4B | -$1.3B | -$1.3B |
| Estimated Cost Of Uncompensated Care | $1.1B | $1.1B | $1.1B | $1.1B | $1.1B | $1.2B | $1.2B | $1.3B |
| Capital Expenditures | $1.3B | $1.2B | $1.3B | $991.0M | $1.2B | $1.3B | $1.5B | $1.1B |
| Payments to Acquire Property, Plant, and Equipment | $1.3B | $1.2B | $1.3B | $991.0M | $1.2B | $1.3B | $1.5B | $1.1B |
| Accounts payable and other current liabilities | $58.0M | $536.0M | $282.0M | -$1.0B | $324.0M | $705.0M | $637.0M | -$990.0M |
| Cash Provided by (Used in) Financing Activity, Including Discontinued Operation | -$1.1B | -$110.0M | -$2.2B | -$1.5B | -$3.1B | -$3.0B | -$999.0M | -$830.0M |
| Interest Paid, Net | $405.0M | $462.0M | $533.0M | $539.0M | $535.0M | $622.0M | $511.0M | $569.0M |
| Interest Paid, Excluding Capitalized Interest, Operating Activity | $405.0M | $462.0M | $533.0M | $539.0M | $535.0M | $622.0M | $511.0M | $569.0M |
| Estimated Cost Of Charity Care | $415.0M | $416.0M | $377.0M | $350.0M | $395.0M | $408.0M | $431.0M | $507.0M |
| Change in Accounts Receivable | $195.0M | -$340.0M | $854.0M | $327.0M | -$647.0M | -$25.0M | $439.0M | $463.0M |
| Increase (Decrease) in Accounts Receivable | $195.0M | -$340.0M | $854.0M | $327.0M | -$647.0M | -$25.0M | $439.0M | $463.0M |
| Deferred and other income taxes | -$448.0M | -$63.0M | $89.0M | $492.0M | $388.0M | $434.0M | — | $435.0M |
| Payments To Acquire Interest In Subsidiaries And Affiliates | $35.0M | $93.0M | $42.0M | $227.0M | $99.0M | $35.0M | $36.0M | $265.0M |
| Financing — other | -$16.0M | -$12.0M | -$53.0M | -$90.0M | -$22.0M | -$30.0M | -$43.0M | -$262.0M |
| OCI Attributable to Noncontrolling Interest | $226.0M | $212.0M | $248.0M | $215.0M | $238.0M | $260.0M | $285.0M | $237.0M |
| Less: comprehensive income attributable to noncontrolling interest | $226.0M | $212.0M | $248.0M | $215.0M | $238.0M | $260.0M | $285.0M | $237.0M |
| Net Income Loss Attributable To Noncontrolling Interest | $226.0M | $212.0M | $248.0M | $215.0M | $238.0M | $260.0M | $285.0M | $237.0M |
| Comprehensive Income Attributable to Noncontrolling Interests | $226.0M | $212.0M | $248.0M | $215.0M | $238.0M | $260.0M | $285.0M | $237.0M |
| Comprehensive Income, Noncontrolling Interest | $226.0M | $212.0M | $248.0M | $215.0M | $238.0M | $260.0M | $285.0M | $237.0M |
| Minority Interest Decrease From Distributions To Noncontrolling Interest Holders | $186.0M | $192.0M | $181.0M | $220.0M | $174.0M | $237.0M | $196.0M | $191.0M |
| Payments to Noncontrolling Interests | — | — | — | $220.0M | — | — | — | $191.0M |
| Payments of Dividends | $171.0M | $169.0M | $165.0M | $180.0M | $171.0M | $166.0M | $162.0M | $183.0M |
| Dividends, Common Stock, Cash | $174.0M | $170.0M | $168.0M | $178.0M | $173.0M | $169.0M | $164.0M | $176.0M |
| Share-Based Payment Arrangement, Expense, Tax Benefit | $10.0M | $14.0M | $9.0M | $24.0M | $9.0M | $12.0M | $16.0M | $103.0M |
| Payments For Proceeds From Investments | $16.0M | $71.0M | $30.0M | -$28.0M | -$13.0M | $67.0M | -$98.0M | -$103.0M |
| Cash, Cash Equivalent, Restricted Cash, and Restricted Cash Equivalent, Period Increase (Decrease), Including Exchange Rate Effect and Discontinued Operation | — | — | — | -$873.0M | — | — | — | -$100.0M |
| Stock-based compensation | $112.0M | $76.0M | $85.0M | $98.0M | $99.0M | $104.0M | $100.0M | $86.0M |
| Increase Decrease In Inventories And Other Operating Assets | $145.0M | -$252.0M | -$150.0M | $360.0M | $67.0M | — | $29.0M | -$80.0M |
| Other Noncash Income (Expense) | -$87.0M | -$37.0M | -$61.0M | -$53.0M | -$48.0M | -$45.0M | -$49.0M | -$67.0M |
| Repayments of Long-Term Debt | $203.0M | $77.0M | $64.0M | $3.9B | $1.8B | $174.0M | $1.6B | $58.0M |
| Other Comprehensive Income (Loss), Before Tax | $0.0 | $67.0M | — | $36.0M | $58.0M | -$11.0M | $17.0M | -$25.0M |
| OCI Foreign Currency Gain (Loss) Before Reclassification and Tax | $1.0M | $55.0M | -$64.0M | $30.0M | $55.0M | -$14.0M | — | -$24.0M |
| Foreign Currency Translation Adjustments, Net | $1.0M | $55.0M | -$64.0M | $30.0M | $55.0M | -$14.0M | — | -$24.0M |
| OCI Foreign Currency Translation Adjustment, Before Tax | $1.0M | $55.0M | -$64.0M | $30.0M | $55.0M | -$14.0M | — | -$24.0M |
| OCI Foreign Currency Gain (Loss), Pre-tax | $1.0M | $55.0M | -$64.0M | $30.0M | $55.0M | -$14.0M | — | -$24.0M |
| Other comprehensive income (loss) | $0.0 | $55.0M | — | $30.0M | $48.0M | -$8.0M | $12.0M | -$22.0M |
| Stockholders Equity Period Increase Decrease Other | -$14.0M | -$4.0M | $21.0M | $21.0M | $12.0M | -$11.0M | -$8.0M | $22.0M |
| Other comprehensive income (loss), net of tax | $0.0 | $46.0M | -$54.0M | $26.0M | $45.0M | — | — | -$21.0M |
| Foreign currency translation gains (losses) | $0.0 | $46.0M | -$54.0M | $26.0M | $45.0M | — | — | -$21.0M |
| Foreign Currency Translation Adjustment, Net of Tax | $0.0 | $46.0M | -$54.0M | $26.0M | $45.0M | — | — | -$21.0M |
| Amortization Of Financing Costs And Discounts | $8.0M | $9.0M | $9.0M | $11.0M | $14.0M | $7.0M | $12.0M | $11.0M |
| Income Taxes Paid, Net | $998.0M | $487.0M | $358.0M | $10.0M | $136.0M | $81.0M | $1.5B | -$5.0M |
| Income Taxes Paid, Net | $998.0M | $487.0M | $358.0M | $10.0M | $136.0M | $81.0M | $1.5B | -$5.0M |
| Payment for (Proceeds from) Other Investing Activity | $1.0M | -$2.0M | $5.0M | $3.0M | -$5.0M | $8.0M | -$18.0M | $4.0M |
| Stock Repurchased During Period Shares | — | — | 17.8M | 7.8M | — | — | 26.7M | 3.2M |
| Add: dilutive effect of potential common shares (in shares) | $2.9M | $3.2M | — | $2.5M | $2.7M | $3.3M | $238.0K | $3.1M |
| Other Comprehensive Income Foreign Currency Translation Adjustment Tax Expense | — | $7.0M | — | $4.0M | $10.0M | — | — | $3.0M |
| Tax expense (benefit) | $0.0 | $12.0M | $3.0M | $6.0M | $10.0M | -$3.0M | $5.0M | -$3.0M |
| Proceeds from principal business dispositions | $1.0M | $1.0M | $16.0M | $161.0M | $6.0M | $10.0M | $92.0M | $3.0M |
| Other Comprehensive Income Tax | $0.0 | $12.0M | $3.0M | $6.0M | $10.0M | -$3.0M | $5.0M | -$3.0M |
| Other Comprehensive Income (Loss), Tax | $0.0 | $12.0M | $3.0M | $6.0M | $10.0M | -$3.0M | $5.0M | -$3.0M |
| Effect of exchange rate changes on cash, cash equivalents and restricted cash | — | — | — | $3.0M | — | — | — | -$2.0M |
| OCI Unrealized Holding Gain (Loss) on Securities, Net of Tax | -$1.0M | $10.0M | — | $4.0M | $3.0M | $2.0M | $1.0M | -$1.0M |
| Unrealized Gain (Loss) on Securities | -$1.0M | $13.0M | — | $6.0M | $3.0M | $3.0M | $1.0M | -$1.0M |
| OCI Unrealized Holding Gain (Loss) on Securities, Before Tax | -$1.0M | $13.0M | — | $6.0M | $3.0M | $3.0M | $1.0M | -$1.0M |
| OCI Unrealized Holding Gain (Loss) on Securities, Net of Tax | -$1.0M | $10.0M | — | $4.0M | $3.0M | $2.0M | $1.0M | -$1.0M |
| Gain/(loss) on dispositions, net | $12.0M | -$4.0M | — | $1.0M | -$3.0M | -$2.0M | $41.0M | -$1.0M |
| Net unrealized gains (losses) on securities still held | -$1.0M | $10.0M | — | $4.0M | $3.0M | $2.0M | $1.0M | -$1.0M |
| OCI Available-for-Sale Debt Securities, Before Tax | -$1.0M | $13.0M | — | $6.0M | $3.0M | $3.0M | $1.0M | -$1.0M |
| Average price paid (in dollars per share) | — | — | $337.74 | $322.84 | — | — | $374.54 | $497.63 |
| Number of reportable segments | — | — | — | 3.00 | — | — | — | 3.00 |
| Revenue Ratio | 100.0% | 100.0% | 100.0% | 100.0% | 100.0% | 100.0% | 100.0% | 100.0% |
| Common Stock Dividends Per Share Declared | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.8 |
| Common Stock Dividends Per Share | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.8 |
| Dividends per share declared | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.8 |
| Dividends per share declared | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.8 |
| Common Stock Dividends Per Share Declared | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.8 |
| Dividends declared (in dollars per share) | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.8 |
| Common Stock Dividends Per Share Declared | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.8 |
| Common Stock Dividends Per Share Declared | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.7 | $0.8 |
| Effective Income Tax Rate Reconciliation Excluding Net Income Attributable To Noncontrolling Interests | — | — | — | 23.8% | — | — | — | 21.0% |
| Income taxes at U.S. statutory rate of 21% | $0.3 | $0.3 | — | $0.2 | $0.2 | $0.2 | — | $0.2 |
| Cost To Charges Ratio | 10.1% | 10.3% | 10.1% | 9.6% | 9.7% | 10.0% | 9.6% | 9.2% |
| Adjustments To Estimated Medicare And Medicaid Reimbursement Amounts And Disproportionate Share Funds Resulting In Net Increases To Revenues Related To Cost Reports Filed During Respective Year | $10.5M | $10.5M | $10.5M | $7.8M | $7.8M | $7.8M | $7.8M | — |
| Adjustments To Estimated Reimbursement Amounts Resulting In Net Increases To Revenues Related To Primarily Cost Reports Filed During Previous Years | $19.5M | $19.5M | $19.5M | $8.0M | $8.0M | $8.0M | $8.0M | — |
| Amortization of capitalized software and acquired intangible assets | $4.0M | $4.0M | $4.0M | $3.0M | $3.0M | $3.0M | $3.0M | — |
| Federal | $300.5M | $300.5M | $300.5M | $387.8M | $387.8M | $387.8M | $387.8M | — |
| Foreign | $5.0M | $5.0M | $5.0M | $3.3M | $3.3M | $3.3M | $3.3M | — |
| Federal | $98.5M | $98.5M | $98.5M | $50.3M | $50.3M | $50.3M | $50.3M | — |
| State | $7.8M | $7.8M | $7.8M | $7.8M | $7.8M | $7.8M | $7.8M | — |
| Depreciation | $823.5M | $823.5M | $823.5M | $877.0M | $877.0M | $877.0M | $877.0M | — |
| Foreign operations | $0.0 | $0.0 | $0.0 | $0.0 | $0.0 | $0.0 | $0.0 | — |
| Effective Income Tax Rate Reconciliation Internal Restructuring Of Affiliates Percent | — | — | 3.2% | — | — | — | 0.0% | — |
| Effective Income Tax Rate Reconciliation Internal Restructuring Of Affiliates Amount | $66.3M | $66.3M | $66.3M | $0.0 | $0.0 | $0.0 | $0.0 | — |
| Effective Income Tax Rate Reconciliation, Noncontrolling Interest Income (Loss), Percent | $0.0 | $0.0 | $0.0 | $0.0 | $0.0 | $0.0 | $0.0 | — |
| Effective Income Tax Rate Reconciliation Other Reconciling Items Percent | — | — | 0.6% | — | — | — | 0.5% | — |
| Excess tax benefits associated with employee equity plans (in percent) | — | — | -1.1% | — | — | — | -0.6% | — |
| State income taxes – net of federal income tax benefit | $0.0 | $0.0 | $0.0 | $0.0 | $0.0 | $0.0 | $0.0 | — |
| Changes in unrecognized tax benefits | — | — | -2.1% | — | — | — | -0.2% | — |
| Estimated Implicit Price Concessions | $1.9B | $1.9B | $1.9B | $1.9B | $1.9B | $1.9B | $1.9B | — |
| Facilities Insured By Wholly Owned Insurance Subsidiary For Losses Maximum Amount | $20.0M | $20.0M | $20.0M | $27.5M | $27.5M | $27.5M | $27.5M | — |
| Acquired intangibles | $68.5M | $68.5M | $68.5M | $68.5M | $68.5M | $68.5M | $68.5M | — |
| Foreign Currency Translation Amortization And Other | -$5.5M | -$5.5M | -$5.5M | -$4.5M | -$4.5M | -$4.5M | -$4.5M | — |
| Goodwill Additions | $42.5M | $42.5M | $42.5M | $54.5M | $54.5M | $54.5M | $54.5M | — |
| Goodwill And Other Intangible Assets Acquired During Period | $42.5M | $42.5M | $42.5M | $54.5M | $54.5M | $54.5M | $54.5M | — |
| Goodwill impairment losses | $0.0 | $0.0 | $0.0 | $0.0 | $0.0 | $0.0 | $0.0 | — |
| Income Tax Examination Interest Expense Net Of Tax | $29.5M | $29.5M | $29.5M | — | — | — | — | — |
| Income tax expense related to remeasurement of deferred tax assets and liabilities | $69.0M | $69.0M | $69.0M | — | — | — | — | — |
| Effective Income Tax Rate Reconciliation at Federal Statutory Income Tax Rate, Amount | $447.5M | $447.5M | $447.5M | $516.3M | $516.3M | $516.3M | $516.3M | — |
| Effective Income Tax Rate Reconciliation, Noncontrolling Interest Income (Loss), Amount | $47.0M | $47.0M | $47.0M | $52.5M | $52.5M | $52.5M | $52.5M | — |
| Effective Income Tax Rate Reconciliation, Other Adjustments, Amount | $250.0K | $250.0K | $250.0K | $750.0K | $750.0K | $750.0K | $750.0K | — |
| Effective Income Tax Rate Reconciliation, State and Local Income Taxes, Amount | $51.5M | $51.5M | $51.5M | $57.0M | $57.0M | $57.0M | $57.0M | — |
| Changes in unrecognized tax benefits | -$44.3M | -$44.3M | -$44.3M | -$4.5M | -$4.5M | -$4.5M | -$4.5M | — |
| Other Comprehensive Income Defined Benefit Plans Net Unamortized Gain Arising During Period Tax Expense | $3.8M | $3.8M | $3.8M | $1.8M | $1.8M | $1.8M | $1.8M | — |
| Other Comprehensive Income Reclassified Interest Benefit On Derivatives Arising During Period Tax Expense | — | — | — | $500.0K | $500.0K | $500.0K | $500.0K | — |
| Payments of Debt Issuance Costs | — | $27.0M | — | $57.0M | — | — | $22.0M | $0.0 |
| Debt issued (Note 13) | — | $3.0B | — | $5.2B | — | — | $3.2B | $0.0 |
| Professional And General Liability Claims Payments Net | $150.0M | $150.0M | $150.0M | $175.5M | $175.5M | $175.5M | $175.5M | — |
| Provisions For Losses Related To Professional Liability Risks | $156.8M | $156.8M | $156.8M | $162.8M | $162.8M | $162.8M | $162.8M | — |
| Reinsurance For Professional Liability Risks Retention Level Of Amount | $8.8M | $8.8M | $8.8M | $8.8M | $8.8M | $8.8M | $8.8M | — |
| Reinsurance For Professional Liability Risks Retention Minimum Level Of Amount | $6.3M | $6.3M | $6.3M | $6.3M | $6.3M | $6.3M | $6.3M | — |
| Self Insured Retention Amount | $3.8M | $3.8M | $3.8M | $3.8M | $3.8M | $3.8M | $3.8M | — |
| Expected volatility | — | — | 33.0% | — | — | — | 33.0% | — |
| Risk-free rate | — | — | 3.9% | — | — | — | 4.3% | — |
| Weighted-average dividend yield | — | — | 0.9% | — | — | — | 0.9% | — |
| Options canceled (in dollars per share) | — | — | $246.78 | — | — | — | $308.57 | — |
| Granted (in shares) | — | — | $305.44 | — | — | — | $329.80 | — |
| Exercised (in shares) | — | — | $111.02 | — | — | — | $125.10 | — |
| Tax Cuts And Jobs Act Of2017Income Tax Examination Change In Tax Rate | $45.3M | $45.3M | $45.3M | — | — | — | — | — |
| Tax Cuts And Jobs Act Of2017Income Tax Examination Interest Expense Net Of Tax | $11.8M | $11.8M | $11.8M | — | — | — | — | — |
| Unrecognized tax benefits, settlements | $4.3M | $4.3M | $4.3M | $250.0K | $250.0K | $250.0K | $250.0K | — |
| Unrecognized Tax Benefits Increase Decrease Resulting From Current Period Tax Positions | $10.0M | $10.0M | $10.0M | $5.3M | $5.3M | $5.3M | $5.3M | — |
| Additions for tax positions of prior years | $15.8M | $15.8M | $15.8M | $6.3M | $6.3M | $6.3M | $6.3M | — |
| Recognition of Net Gains/Losses on Benefit Obligations, Net of Taxes | $12.5M | $12.5M | $12.5M | $6.0M | $6.0M | $6.0M | $6.0M | — |
| Amortization of Actuarial Gain, Net of Tax | $12.5M | $12.5M | $12.5M | $6.0M | $6.0M | $6.0M | $6.0M | — |
