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Financial Instruments - Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Details) - USD ($)
$ in Millions
3 Months Ended
Mar. 31, 2019
Dec. 31, 2018
Mar. 31, 2018
Dec. 31, 2017
Assets        
Investments $ 6,343 $ 7,261    
Investments 636 456    
Derivative assets 384 454    
Liabilities        
Contingent consideration 667 788 $ 919 $ 935
Derivative liabilities 195 160    
Corporate notes and bonds        
Assets        
Investments 4,310 4,920    
Asset-backed securities        
Assets        
Investments $ 1,094 1,275    
Liabilities        
Primary weighted average life of collateral 5 years      
U.S. government and agency securities        
Assets        
Investments $ 832 892    
Foreign government bonds        
Assets        
Investments 99 166    
Mortgage-backed securities        
Assets        
Investments 8 8    
Fair Value, Measurements, Recurring        
Assets        
Investments 6,343 7,132    
Other assets 636 585    
Derivative assets 384 454    
Total assets 7,363 8,171    
Liabilities        
Contingent consideration 667 788    
Derivative liabilities 195 160    
Total liabilities 862 948    
Fair Value, Measurements, Recurring | Foreign exchange contracts        
Assets        
Derivative assets 194 241    
Liabilities        
Derivative liabilities 144 74    
Fair Value, Measurements, Recurring | Currency options        
Assets        
Derivative assets 190 213    
Liabilities        
Derivative liabilities 3 5    
Fair Value, Measurements, Recurring | Interest rate swap contracts        
Liabilities        
Derivative liabilities 48 81    
Fair Value, Measurements, Recurring | Quoted Prices In Active Markets for Identical Assets (Level 1)        
Assets        
Investments 209 147    
Other assets 483 364    
Derivative assets 0 0    
Total assets 692 511    
Liabilities        
Contingent consideration 0 0    
Derivative liabilities 0 0    
Total liabilities 0 0    
Fair Value, Measurements, Recurring | Quoted Prices In Active Markets for Identical Assets (Level 1) | Foreign exchange contracts        
Assets        
Derivative assets 0 0    
Liabilities        
Derivative liabilities 0 0    
Fair Value, Measurements, Recurring | Quoted Prices In Active Markets for Identical Assets (Level 1) | Currency options        
Assets        
Derivative assets 0 0    
Liabilities        
Derivative liabilities 0 0    
Fair Value, Measurements, Recurring | Quoted Prices In Active Markets for Identical Assets (Level 1) | Interest rate swap contracts        
Liabilities        
Derivative liabilities 0 0    
Fair Value, Measurements, Recurring | Significant Other Observable Inputs (Level 2)        
Assets        
Investments 6,134 6,985    
Other assets 153 221    
Derivative assets 384 454    
Total assets 6,671 7,660    
Liabilities        
Contingent consideration 0 0    
Derivative liabilities 195 160    
Total liabilities 195 160    
Fair Value, Measurements, Recurring | Significant Other Observable Inputs (Level 2) | Foreign exchange contracts        
Assets        
Derivative assets 194 241    
Liabilities        
Derivative liabilities 144 74    
Fair Value, Measurements, Recurring | Significant Other Observable Inputs (Level 2) | Currency options        
Assets        
Derivative assets 190 213    
Liabilities        
Derivative liabilities 3 5    
Fair Value, Measurements, Recurring | Significant Other Observable Inputs (Level 2) | Interest rate swap contracts        
Liabilities        
Derivative liabilities 48 81    
Fair Value, Measurements, Recurring | Significant Unobservable Inputs (Level 3)        
Assets        
Investments 0 0    
Other assets 0 0    
Derivative assets 0 0    
Total assets 0 0    
Liabilities        
Contingent consideration 667 788    
Derivative liabilities 0 0    
Total liabilities 667 788    
Fair Value, Measurements, Recurring | Significant Unobservable Inputs (Level 3) | Foreign exchange contracts        
Assets        
Derivative assets 0 0    
Liabilities        
Derivative liabilities 0 0    
Fair Value, Measurements, Recurring | Significant Unobservable Inputs (Level 3) | Currency options        
Assets        
Derivative assets 0 0    
Liabilities        
Derivative liabilities 0 0    
Fair Value, Measurements, Recurring | Significant Unobservable Inputs (Level 3) | Interest rate swap contracts        
Liabilities        
Derivative liabilities 0 0    
Fair Value, Measurements, Recurring | Corporate notes and bonds        
Assets        
Investments 4,231 4,835    
Other assets 79 85    
Fair Value, Measurements, Recurring | Corporate notes and bonds | Quoted Prices In Active Markets for Identical Assets (Level 1)        
Assets        
Investments 0 0    
Other assets 0 0    
Fair Value, Measurements, Recurring | Corporate notes and bonds | Significant Other Observable Inputs (Level 2)        
Assets        
Investments 4,231 4,835    
Other assets 79 85    
Fair Value, Measurements, Recurring | Corporate notes and bonds | Significant Unobservable Inputs (Level 3)        
Assets        
Investments 0 0    
Other assets 0 0    
Fair Value, Measurements, Recurring | Asset-backed securities        
Assets        
Investments 1,069 1,253    
Other assets 25 22    
Fair Value, Measurements, Recurring | Asset-backed securities | Quoted Prices In Active Markets for Identical Assets (Level 1)        
Assets        
Investments 0 0    
Other assets 0 0    
Fair Value, Measurements, Recurring | Asset-backed securities | Significant Other Observable Inputs (Level 2)        
Assets        
Investments 1,069 1,253    
Other assets 25 22    
Fair Value, Measurements, Recurring | Asset-backed securities | Significant Unobservable Inputs (Level 3)        
Assets        
Investments 0 0    
Other assets 0 0    
Fair Value, Measurements, Recurring | U.S. government and agency securities        
Assets        
Investments 735 731    
Other assets 97 161    
Fair Value, Measurements, Recurring | U.S. government and agency securities | Quoted Prices In Active Markets for Identical Assets (Level 1)        
Assets        
Investments 0 0    
Other assets 56 55    
Fair Value, Measurements, Recurring | U.S. government and agency securities | Significant Other Observable Inputs (Level 2)        
Assets        
Investments 735 731    
Other assets 41 106    
Fair Value, Measurements, Recurring | U.S. government and agency securities | Significant Unobservable Inputs (Level 3)        
Assets        
Investments 0 0    
Other assets 0 0    
Fair Value, Measurements, Recurring | Foreign government bonds        
Assets        
Investments 99 166    
Fair Value, Measurements, Recurring | Foreign government bonds | Quoted Prices In Active Markets for Identical Assets (Level 1)        
Assets        
Investments 0 0    
Fair Value, Measurements, Recurring | Foreign government bonds | Significant Other Observable Inputs (Level 2)        
Assets        
Investments 99 166    
Fair Value, Measurements, Recurring | Foreign government bonds | Significant Unobservable Inputs (Level 3)        
Assets        
Investments 0 0    
Fair Value, Measurements, Recurring | Mortgage-backed securities        
Assets        
Other assets 8 8    
Fair Value, Measurements, Recurring | Mortgage-backed securities | Quoted Prices In Active Markets for Identical Assets (Level 1)        
Assets        
Other assets 0 0    
Fair Value, Measurements, Recurring | Mortgage-backed securities | Significant Other Observable Inputs (Level 2)        
Assets        
Other assets 8 8    
Fair Value, Measurements, Recurring | Mortgage-backed securities | Significant Unobservable Inputs (Level 3)        
Assets        
Other assets 0 0    
Fair Value, Measurements, Recurring | Publicly traded equity securities        
Assets        
Investments 209 147    
Other assets 427 309    
Fair Value, Measurements, Recurring | Publicly traded equity securities | Quoted Prices In Active Markets for Identical Assets (Level 1)        
Assets        
Investments 209 147    
Other assets 427 309    
Fair Value, Measurements, Recurring | Publicly traded equity securities | Significant Other Observable Inputs (Level 2)        
Assets        
Investments 0 0    
Other assets 0 0    
Fair Value, Measurements, Recurring | Publicly traded equity securities | Significant Unobservable Inputs (Level 3)        
Assets        
Investments 0 0    
Other assets $ 0 $ 0