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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
 6 Months Ended
Jun. 30, 2024
Jun. 30, 2023
Cash flows from operating activities    
Net income including non-controlling interests $ 345 $ 237
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 375 415
Bad debt expense 35 44
Stock-based compensation 939 974
Deferred income taxes (23) 16
Loss (income) from equity method investments, net 16 (40)
Unrealized (gain) loss on debt and equity securities, net 388 (706)
Loss from sale of investment 0 74
Impairments of goodwill, long-lived assets and other assets 0 78
Unrealized foreign currency transactions 209 85
Other (138) 10
Change in assets and liabilities, net of impact of business acquisitions and disposals:    
Accounts receivable (584) 155
Prepaid expenses and other assets (430) (233)
Operating lease right-of-use assets 93 94
Accounts payable (24) (26)
Accrued insurance reserves 1,385 938
Accrued expenses and other liabilities 731 (229)
Operating lease liabilities (81) (90)
Net cash provided by operating activities 3,236 1,796
Cash flows from investing activities    
Purchases of property and equipment (156) (107)
Purchases of non-marketable equity securities (232) 0
Purchases of marketable securities (5,317) (2,207)
Proceeds from maturities and sales of marketable securities 3,851 1,627
Proceeds from sale of equity method investment 17 703
Other investing activities (81) (7)
Net cash provided by (used in) investing activities (1,918) 9
Cash flows from financing activities    
Issuance of term loans and notes, net of issuance costs 0 1,121
Principal repayment on term loan and notes (13) (1,144)
Principal payments on finance leases (77) (82)
Proceeds from the issuance of common stock under the Employee Stock Purchase Plan 103 85
Repurchases of common stock (325) 0
Other financing activities 21 (45)
Net cash used in financing activities (291) (65)
Effect of exchange rate changes on cash and cash equivalents, and restricted cash and cash equivalents (150) 43
Net increase in cash and cash equivalents, and restricted cash and cash equivalents 877 1,783
Cash and cash equivalents, and restricted cash and cash equivalents    
Beginning of period 7,004 6,677
End of period 7,881 8,460
Reconciliation of cash and cash equivalents, and restricted cash and cash equivalents to the condensed consolidated balance sheets    
Cash and cash equivalents 4,497 4,995
Restricted cash and cash equivalents-current 776 909
Restricted cash and cash equivalents-non-current 2,608 2,556
Total cash and cash equivalents, and restricted cash and cash equivalents 7,881 8,460
Cash paid for:    
Interest, net of amount capitalized 260 312
Income taxes, net of refunds 157 70
Non-cash investing and financing activities:    
Finance lease obligations 2 163
Right-of-use assets obtained in exchange for lease obligations $ 42 $ 30