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Income Tax Reconciliation of the tax provision at the U.S. Federal Statutory Rate (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Income Tax Contingency [Line Items]
Tax provision at the U.S. federal statutory rate, Amount	$ 4,356	$ 3,776	$ 3,348
Tax provision at the U.S. federal statutory rate, Percent	21.00%	21.00%	21.00%
State income taxes, net of federal benefit, Amount	$ 315	$ 271	$ 168
State income taxes, net of federal benefit, Percent	1.50%	1.50%	1.00%
Share-based awards - excess tax benefit, Amount	$ (130)	$ (132)	$ (161)
Share-based awards - excess tax benefit, Percent	(0.60%)	(0.70%)	(1.00%)
Non-deductible compensation, Amount	$ 134	$ 119	$ 117
Non-deductible compensation, Percent	0.70%	0.70%	0.70%
Health insurance tax, Amount	$ 626	$ 0	$ 552
Health insurance tax, Percent	3.00%	0.00%	3.50%
Foreign rate differential, Amount	$ (164)	$ (214)	$ (203)
Foreign rate differential, Percent	(0.80%)	(1.20%)	(1.30%)
Other, net, Amount	$ (164)	$ (78)	$ (259)
Other, net, Percent	(0.80%)	(0.50%)	(1.60%)
Total provision for income taxes	$ 4,973	$ 3,742	$ 3,562
Provision for income taxes, Percent	24.00%	20.80%	22.30%

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