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Fair value measurement (Details) - USD ($) $ in Millions | Sep. 30, 2017 | Jun. 30, 2017 | Dec. 31, 2016 | Sep. 30, 2016 | Jun. 30, 2016 | Dec. 31, 2015
--- | --- | --- | --- | --- | --- | ---
Assets: |  |  |  |  |  |
Total available-for-sale investments | $ 40,949 |  | $ 37,781 |  |  |
Fair Value, Measurements, Recurring [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Total assets | 41,230 |  | 38,025 |  |  |
Derivatives: |  |  |  |  |  |
Contingent consideration obligations in connection with business combinations | 68 |  | 179 |  |  |
Total liabilities | 560 |  | 713 |  |  |
Fair Value, Measurements, Recurring [Member] | Foreign currency contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 7 |  | 203 |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 179 |  | 4 |  |  |
Fair Value, Measurements, Recurring [Member] | Cross currency swap contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 224 |  |  |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 308 |  | 523 |  |  |
Fair Value, Measurements, Recurring [Member] | Interest rate swap contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Interest rate contracts | 40 |  | 41 |  |  |
Derivatives: |  |  |  |  |  |
Interest rate swap contracts | 5 |  | 7 |  |  |
Fair Value, Measurements, Recurring [Member] | Forward interest rate contract [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Interest rate contracts | 10 |  |  |  |  |
Fair Value, Measurements, Recurring [Member] | U.S. Treasury securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 8,018 |  | 6,614 |  |  |
Fair Value, Measurements, Recurring [Member] | Other government-related debt securities - U.S. [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 224 |  | 299 |  |  |
Fair Value, Measurements, Recurring [Member] | Other government-related debt securities - Foreign and other [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 2,671 |  | 1,759 |  |  |
Fair Value, Measurements, Recurring [Member] | Corporate debt securities - Financial [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 10,254 |  | 8,460 |  |  |
Fair Value, Measurements, Recurring [Member] | Corporate debt securities - Industrial [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 9,906 |  | 8,789 |  |  |
Fair Value, Measurements, Recurring [Member] | Corporate debt securities - Other [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 1,261 |  | 1,077 |  |  |
Fair Value, Measurements, Recurring [Member] | Residential mortgage-backed securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 2,204 |  | 1,940 |  |  |
Fair Value, Measurements, Recurring [Member] | Other mortgage- and asset-backed securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 2,067 |  | 1,719 |  |  |
Fair Value, Measurements, Recurring [Member] | Money market mutual funds [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 2,455 |  | 2,782 |  |  |
Fair Value, Measurements, Recurring [Member] | Other short-term interest-bearing securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 1,746 |  | 4,188 |  |  |
Fair Value, Measurements, Recurring [Member] | Equity securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 143 |  | 154 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Total assets | 10,616 |  | 9,550 |  |  |
Derivatives: |  |  |  |  |  |
Contingent consideration obligations in connection with business combinations | 0 |  | 0 |  |  |
Total liabilities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Foreign currency contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 0 |  | 0 |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Cross currency swap contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 0 |  |  |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Interest rate swap contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Interest rate contracts | 0 |  | 0 |  |  |
Derivatives: |  |  |  |  |  |
Interest rate swap contracts | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Forward interest rate contract [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Interest rate contracts | 0 |  |  |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | U.S. Treasury securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 8,018 |  | 6,614 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Other government-related debt securities - U.S. [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Other government-related debt securities - Foreign and other [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Corporate debt securities - Financial [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Corporate debt securities - Industrial [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Corporate debt securities - Other [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Residential mortgage-backed securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Other mortgage- and asset-backed securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Money market mutual funds [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 2,455 |  | 2,782 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Other short-term interest-bearing securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Equity securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 143 |  | 154 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Total assets | 30,614 |  | 28,475 |  |  |
Derivatives: |  |  |  |  |  |
Contingent consideration obligations in connection with business combinations | 0 |  | 0 |  |  |
Total liabilities | 492 |  | 534 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Foreign currency contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 7 |  | 203 |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 179 |  | 4 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Cross currency swap contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 224 |  |  |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 308 |  | 523 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Interest rate swap contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Interest rate contracts | 40 |  | 41 |  |  |
Derivatives: |  |  |  |  |  |
Interest rate swap contracts | 5 |  | 7 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Forward interest rate contract [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Interest rate contracts | 10 |  |  |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | U.S. Treasury securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Other government-related debt securities - U.S. [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 224 |  | 299 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Other government-related debt securities - Foreign and other [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 2,671 |  | 1,759 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Corporate debt securities - Financial [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 10,254 |  | 8,460 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Corporate debt securities - Industrial [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 9,906 |  | 8,789 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Corporate debt securities - Other [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 1,261 |  | 1,077 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Residential mortgage-backed securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 2,204 |  | 1,940 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Other mortgage- and asset-backed securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 2,067 |  | 1,719 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Money market mutual funds [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Other short-term interest-bearing securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 1,746 |  | 4,188 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Equity securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Total assets | 0 |  | 0 |  |  |
Derivatives: |  |  |  |  |  |
Contingent consideration obligations in connection with business combinations | 68 | $ 182 | 179 | $ 176 | $ 171 | $ 188
Total liabilities | 68 |  | 179 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Foreign currency contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 0 |  | 0 |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Cross currency swap contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 0 |  |  |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Interest rate swap contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Interest rate contracts | 0 |  | 0 |  |  |
Derivatives: |  |  |  |  |  |
Interest rate swap contracts | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Forward interest rate contract [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Interest rate contracts | 0 |  |  |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | U.S. Treasury securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Other government-related debt securities - U.S. [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Other government-related debt securities - Foreign and other [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Corporate debt securities - Financial [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Corporate debt securities - Industrial [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Corporate debt securities - Other [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Residential mortgage-backed securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Other mortgage- and asset-backed securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Money market mutual funds [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Other short-term interest-bearing securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Equity securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Total available-for-sale investments | $ 0 |  | $ 0 |  |  |

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- Definition Fair value portion of probable future economic benefits obtained or controlled by an entity as a result of past transactions or events. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 820 -SubTopic 10 -Section 50 -Paragraph 2 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=66048111&loc=d3e19207-110258 + Details
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