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Consolidated Statement of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Cash Flow From (Used in) Operating Activities:      
Net earnings $ 4,495 $ 3,687 $ 2,368
Adjustments to reconcile earnings to net cash from operating activities -      
Depreciation 1,195 1,078 1,100
Amortization of intangible assets 2,132 1,936 2,178
Share-based compensation 546 519 477
Amortization of inventory step-up     32
Investing and financing losses, net 425 184 126
Loss on extinguishment of debt   63 167
Trade receivables (924) (275) (190)
Inventories (493) (593) (514)
Prepaid expenses and other assets (627) (138) 23
Trade accounts payable and other liabilities 1,766 220 747
Income taxes (614) (545) (214)
Net Cash From Operating Activities 7,901 6,136 6,300
Cash Flow From (Used in) Investing Activities:      
Acquisitions of property and equipment (2,177) (1,638) (1,394)
Acquisitions of businesses and technologies, net of cash acquired (42) (170) (54)
Proceeds from business dispositions 58 48 48
Purchases of investment securities (83) (103) (131)
Proceeds from sales of investment securities 10 21 73
Other 19 27 102
Net Cash From (Used in) Investing Activities (2,215) (1,815) (1,356)
Cash Flow From (Used in) Financing Activities:      
Proceeds from issuance of (repayments of) short-term debt, net and other 2   (26)
Proceeds from issuance of long-term debt and debt with maturities over 3 months 1,281 1,842 4,009
Repayments of long-term debt and debt with maturities over 3 months (1,333) (3,441) (12,433)
Purchases of common shares (403) (718) (238)
Proceeds from stock options exercised 245 298 271
Dividends paid (2,560) (2,270) (1,974)
Other (11)    
Net Cash From (Used in) Financing Activities (2,779) (4,289) (10,391)
Effect of exchange rate changes on cash and cash equivalents 71 (16) (116)
Net Increase (Decrease) in Cash and Cash Equivalents 2,978 16 (5,563)
Cash and Cash Equivalents, Beginning of Year 3,860 3,844 9,407
Cash and Cash Equivalents, End of Year 6,838 3,860 3,844
Supplemental Cash Flow Information:      
Income taxes paid 970 930 740
Interest paid $ 549 $ 677 $ 845