SHELF
                             UNDERWRITING AGREEMENT

                                 March 9, 1994

Columbia/HCA Healthcare Corporation
201 West Main Street
Louisville, Kentucky 40202

Dear Sirs:

    We  (the "Managers") are acting on behalf of the underwriter or underwriters
(including ourselves) named below (such underwriter or underwriters being herein
called the  "Underwriters"),  and  we understand  that  Columbia/HCA  Healthcare
Corporation,  a Delaware corporation (the "Company"), proposes to issue and sell
$175,000,000 aggregate principal amount of its  6 1/2% Notes due March 15,  1999
(the  "Notes").  The Notes  are  sometimes referred  to  herein as  the "Offered
Securities." The Offered Securities will be issued pursuant to the provisions of
an Indenture dated as of December 15, 1993 (the "Indenture") between the Company
and The First National Bank of Chicago, as Trustee (the "Trustee").

    Subject to the terms and conditions  set forth or incorporated by  reference
herein,  the  Company  hereby  agrees  to sell  and  the  Underwriters  agree to
purchase, severally and  not jointly,  the respective principal  amounts of  the
Notes set forth below opposite their names at a purchase price of 99.303% of the
principal amount of the Notes.



                                                                              PRINCIPAL AMOUNT
                                                                                  OF NOTES
                                                                              ----------------
                                                                           
Lehman Brothers, Inc........................................................  $     43,750,000
Donaldson, Lufkin & Jenrette Securities Corporation.........................        43,750,000
Merrill Lynch, Pierce, Fenner & Smith
           Incorporated.....................................................        43,750,000
Salomon Brothers Inc........................................................        43,750,000
                                                                              ----------------
  Total.....................................................................  $    175,000,000
                                                                              ----------------
                                                                              ----------------


    The  Underwriters will pay for the  Offered Securities upon delivery thereof
at the offices of Lehman Brothers Inc. at 9:00 a.m. (New York time) on March 16,
1994. The time and date of such payment and delivery are hereinafter referred to
as the Closing Date.

    The Offered Securities  shall have  the terms  set forth  in the  Prospectus
dated  November 22,  1993, and  the Prospectus  Supplement dated  March 9, 1994,
including the following:

Terms of Notes:


                      
Public Offering Price:   99.928% of principal amount
Purchase Price:          99.303% of principal amount
Maturity Date:           March 15, 1999
Interest Rate:           6 1/2%
Redemption Provisions:   Not redeemable prior to maturity
Interest Payment Dates:  March 15 and September  15, commencing September 15,  1994.
                         Interest accrues from March 16, 1994
Current Ratings:         Standard & Poor's Corporation -- BBB+
                         Moody's Investor Service -- A3


    All  provisions contained  in the  document entitled  Underwriting Agreement
Standard Provisions (Debt Securities), a copy  of which is attached hereto,  are
herein  incorporated by reference in their entirety  and shall be deemed to be a
part  of   this  Agreement   to  the   same  extent   as  if   such   provisions

had  been set forth in full herein, except  that (i) if any term defined in such
document is  otherwise defined  herein, the  definition set  forth herein  shall
control,  (ii) all references in such document to a type of security that is not
an Offered Security  shall not be  deemed to be  a part of  this Agreement,  and
(iii)  all references in such document to a  type of agreement that has not been
entered into in connection with  the transactions contemplated hereby shall  not
be deemed to be a part of this Agreement.

    Please confirm your agreement by having an authorized officer sign a copy of
this Agreement in the space set forth below.

                                      Very truly yours,

                                      LEHMAN BROTHERS INC.

                                      DONALDSON, LUFKIN & JENRETTE SECURITIES
                                       CORPORATION

                                      MERRILL LYNCH, PIERCE, FENNER & SMITH
                                       INCORPORATED

                                      SALOMON BROTHERS INC

                                      By: LEHMAN BROTHERS INC.

                                      Acting severally on behalf of itself
                                      and the several Underwriters named herein
                                      By: ______________________________________
                                      Name: ____________________________________
                                      Title: ___________________________________

Accepted:
COLUMBIA/HCA HEALTHCARE
 CORPORATION
By: _____________________________
Name: ___________________________
Title: __________________________

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