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Taxes on Income - Reconciliation Between Effective Tax Rate and US Statutory Rate (Details) - USD ($)
$ in Millions
12 Months Ended
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
Amount      
U.S. statutory rate applied to income before taxes $ 2,282 $ 1,631 $ 1,890
Differential arising from:      
Provisional impact of the TCJA 2,625 0 0
Impact of purchase accounting adjustments, including amortization 713 623 797
Valuation allowances 632 (5) 39
Restructuring 142 145 167
State taxes 77 173 159
U.S. health care reform legislation 74 68 66
Foreign currency devaluation related to Venezuela 0 0 321
Foreign earnings (1,725) (1,646) (2,144)
Tax settlements (356) 0 (417)
Unremitted foreign earnings 0 (30) 260
Other (361) (241) (196)
Taxes on income $ 4,103 $ 718 $ 942
Tax Rate      
U.S. statutory rate applied to income before taxes 35.00% 35.00% 35.00%
Differential arising from:      
Provisional impact of the TCJA 40.30% 0.00% 0.00%
Impact of purchase accounting adjustments, including amortization 10.90% 13.40% 14.80%
Valuation allowances 9.70% (0.10%) 0.70%
Restructuring 2.20% 3.10% 3.10%
State taxes 1.20% 3.70% 2.90%
U.S. health care reform legislation 1.10% 1.40% 1.20%
Foreign currency devaluation related to Venezuela 0.00% 0.00% 5.90%
Foreign earnings (26.50%) (35.30%) (39.70%)
Tax settlements (5.50%) 0.00% (7.70%)
Unremitted foreign earnings 0.00% (0.60%) 4.80%
Other (5.50%) (5.20%) (3.60%)
Total, Tax Rate 62.90% 15.40% 17.40%