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Fair value measurement (Fair Value of Financial Assets and Liabilities on Recurring Basis) (Details) - USD ($) $ in Millions | Dec. 31, 2017 | Dec. 31, 2016 | Dec. 31, 2015 | Dec. 31, 2014
--- | --- | --- | --- | ---
Assets: |  |  |  |
Total available-for-sale investments | $ 41,318 | $ 37,781 |  |
Recurring [Member] |  |  |  |
Derivative Assets: |  |  |  |
Total assets | 41,604 | 38,025 |  |
Derivative Liabilities: |  |  |  |
Contingent consideration obligations in connection with business combinations | 69 | 179 |  |
Total liabilities | 554 | 713 |  |
Recurring [Member] | Foreign currency contracts [Member] |  |  |  |
Derivative Assets: |  |  |  |
Foreign currency contracts | 6 | 203 |  |
Derivative Liabilities: |  |  |  |
Foreign currency contracts | 204 | 4 |  |
Recurring [Member] | Cross-currency swap contracts [Member] |  |  |  |
Derivative Assets: |  |  |  |
Foreign currency contracts | 270 |  |  |
Derivative Liabilities: |  |  |  |
Foreign currency contracts | 220 | 523 |  |
Recurring [Member] | Interest rate swap contracts [Member] |  |  |  |
Derivative Assets: |  |  |  |
Interest rate swap contracts | 10 | 41 |  |
Derivative Liabilities: |  |  |  |
Interest rate swap contracts | 61 | 7 |  |
Recurring [Member] | U.S. Treasury securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 8,242 | 6,614 |  |
Recurring [Member] | Other government-related debt securities - U.S. [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 223 | 299 |  |
Recurring [Member] | Other government-related debt securities - Foreign and other [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 2,422 | 1,759 |  |
Recurring [Member] | Corporate debt securities - Financial [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 10,072 | 8,460 |  |
Recurring [Member] | Corporate debt securities - Industrial [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 9,670 | 8,789 |  |
Recurring [Member] | Corporate debt securities - Other [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 1,390 | 1,077 |  |
Recurring [Member] | Residential mortgage-backed securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 2,168 | 1,940 |  |
Recurring [Member] | Other mortgage- and asset-backed securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 2,297 | 1,719 |  |
Recurring [Member] | Money market mutual funds [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 3,245 | 2,782 |  |
Recurring [Member] | Other short-term interest-bearing securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 1,440 | 4,188 |  |
Recurring [Member] | Equity securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 149 | 154 |  |
Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] |  |  |  |
Derivative Assets: |  |  |  |
Total assets | 11,636 | 9,550 |  |
Derivative Liabilities: |  |  |  |
Contingent consideration obligations in connection with business combinations | 0 | 0 |  |
Total liabilities | 0 | 0 |  |
Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Foreign currency contracts [Member] |  |  |  |
Derivative Assets: |  |  |  |
Foreign currency contracts | 0 | 0 |  |
Derivative Liabilities: |  |  |  |
Foreign currency contracts | 0 | 0 |  |
Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Cross-currency swap contracts [Member] |  |  |  |
Derivative Assets: |  |  |  |
Foreign currency contracts | 0 |  |  |
Derivative Liabilities: |  |  |  |
Foreign currency contracts | 0 | 0 |  |
Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Interest rate swap contracts [Member] |  |  |  |
Derivative Assets: |  |  |  |
Interest rate swap contracts | 0 | 0 |  |
Derivative Liabilities: |  |  |  |
Interest rate swap contracts | 0 | 0 |  |
Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | U.S. Treasury securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 8,242 | 6,614 |  |
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 |  |
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 |  |
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 |  |
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 |  |
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 |  |
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 |  |
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 |  |
Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Money market mutual funds [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 3,245 | 2,782 |  |
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 |  |
Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Equity securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 149 | 154 |  |
Recurring [Member] | Significant other observable inputs (Level 2) [Member] |  |  |  |
Derivative Assets: |  |  |  |
Total assets | 29,968 | 28,475 |  |
Derivative Liabilities: |  |  |  |
Contingent consideration obligations in connection with business combinations | 0 | 0 |  |
Total liabilities | 485 | 534 |  |
Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Foreign currency contracts [Member] |  |  |  |
Derivative Assets: |  |  |  |
Foreign currency contracts | 6 | 203 |  |
Derivative Liabilities: |  |  |  |
Foreign currency contracts | 204 | 4 |  |
Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Cross-currency swap contracts [Member] |  |  |  |
Derivative Assets: |  |  |  |
Foreign currency contracts | 270 |  |  |
Derivative Liabilities: |  |  |  |
Foreign currency contracts | 220 | 523 |  |
Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Interest rate swap contracts [Member] |  |  |  |
Derivative Assets: |  |  |  |
Interest rate swap contracts | 10 | 41 |  |
Derivative Liabilities: |  |  |  |
Interest rate swap contracts | 61 | 7 |  |
Recurring [Member] | Significant other observable inputs (Level 2) [Member] | U.S. Treasury securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 0 | 0 |  |
Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Other government-related debt securities - U.S. [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 223 | 299 |  |
Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Other government-related debt securities - Foreign and other [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 2,422 | 1,759 |  |
Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Corporate debt securities - Financial [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 10,072 | 8,460 |  |
Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Corporate debt securities - Industrial [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 9,670 | 8,789 |  |
Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Corporate debt securities - Other [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 1,390 | 1,077 |  |
Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Residential mortgage-backed securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 2,168 | 1,940 |  |
Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Other mortgage- and asset-backed securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 2,297 | 1,719 |  |
Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Money market mutual funds [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 0 | 0 |  |
Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Other short-term interest-bearing securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 1,440 | 4,188 |  |
Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Equity securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 0 | 0 |  |
Recurring [Member] | Significant unobservable inputs (Level 3) [Member] |  |  |  |
Derivative Assets: |  |  |  |
Total assets |  | 0 |  |
Derivative Liabilities: |  |  |  |
Contingent consideration obligations in connection with business combinations | 69 | 179 | $ 188 | $ 215
Total liabilities | 69 | 179 |  |
Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Foreign currency contracts [Member] |  |  |  |
Derivative Assets: |  |  |  |
Foreign currency contracts | 0 | 0 |  |
Derivative Liabilities: |  |  |  |
Foreign currency contracts | 0 | 0 |  |
Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Cross-currency swap contracts [Member] |  |  |  |
Derivative Assets: |  |  |  |
Foreign currency contracts | 0 |  |  |
Derivative Liabilities: |  |  |  |
Foreign currency contracts | 0 | 0 |  |
Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Interest rate swap contracts [Member] |  |  |  |
Derivative Assets: |  |  |  |
Interest rate swap contracts | 0 | 0 |  |
Derivative Liabilities: |  |  |  |
Interest rate swap contracts | 0 | 0 |  |
Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | U.S. Treasury securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 0 | 0 |  |
Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Other government-related debt securities - U.S. [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 0 | 0 |  |
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 |  |
Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Corporate debt securities - Financial [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 0 | 0 |  |
Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Corporate debt securities - Industrial [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 0 | 0 |  |
Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Corporate debt securities - Other [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 0 | 0 |  |
Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Residential mortgage-backed securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 0 | 0 |  |
Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Other mortgage- and asset-backed securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 0 | 0 |  |
Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Money market mutual funds [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 0 | 0 |  |
Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Other short-term interest-bearing securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | 0 | 0 |  |
Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Equity securities [Member] |  |  |  |
Assets: |  |  |  |
Total available-for-sale investments | $ 0 | $ 0 |  |

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