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Fair value measurement (Details) - USD ($) | Sep. 30, 2018 | Jun. 30, 2018 | Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Dec. 31, 2016
--- | --- | --- | --- | --- | --- | ---
Assets: |  |  |  |  |  |
Interest-bearing securities | $ 29,418,000,000 |  | $ 41,169,000,000 |  |  |
Equity securities | 217,000,000 |  |  |  |  |
Derivatives: |  |  |  |  |  |
Contingent consideration obligations |  |  | 0 |  |  | $ 116,000,000
Fair Value, Measurements, Recurring [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Equity securities | 217,000,000 |  | 149,000,000 |  |  |
Derivatives: |  |  |  |  |  |
Total assets | 30,017,000,000 |  | 41,604,000,000 |  |  |
Derivatives: |  |  |  |  |  |
Contingent consideration obligations | 66,000,000 |  | 69,000,000 |  |  |
Total liabilities | 731,000,000 |  | 554,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Foreign currency contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 121,000,000 |  | 6,000,000 |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 49,000,000 |  | 204,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Cross-currency swap contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 261,000,000 |  | 270,000,000 |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 306,000,000 |  | 220,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Interest rate swap contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Interest rate contracts |  |  | 10,000,000 |  |  |
Derivatives: |  |  |  |  |  |
Interest rate swap contracts | 310,000,000 |  | 61,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | U.S. Treasury notes [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 2,626,000,000 |  | 8,242,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | U.S. Treasury bills [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 5,376,000,000 |  |  |  |  |
Fair Value, Measurements, Recurring [Member] | Other government-related debt securities - U.S. [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 109,000,000 |  | 223,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Other government-related debt securities - Foreign and other [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 1,008,000,000 |  | 2,422,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Corporate debt securities - Financial [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 2,697,000,000 |  | 10,072,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Corporate debt securities - Industrial [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 2,578,000,000 |  | 9,670,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Corporate debt securities - Other [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 573,000,000 |  | 1,390,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Residential mortgage-backed securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 1,462,000,000 |  | 2,168,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Other mortgage- and asset-backed securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 473,000,000 |  | 2,297,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Money market mutual funds [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 8,955,000,000 |  | 3,245,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Other short-term interest-bearing securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 3,561,000,000 |  | 1,440,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Equity securities | 217,000,000 |  | 149,000,000 |  |  |
Derivatives: |  |  |  |  |  |
Total assets | 17,174,000,000 |  | 11,636,000,000 |  |  |
Derivatives: |  |  |  |  |  |
Contingent consideration obligations | 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 |  | 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 |  |  |
Derivatives: |  |  |  |  |  |
Interest rate swap contracts | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | U.S. Treasury notes [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 2,626,000,000 |  | 8,242,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | U.S. Treasury bills [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 5,376,000,000 |  |  |  |  |
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: |  |  |  |  |  |
Interest-bearing securities | 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: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Corporate debt securities - Financial [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Corporate debt securities - Industrial [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Corporate debt securities - Other [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Residential mortgage-backed securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 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: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Money market mutual funds [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 8,955,000,000 |  | 3,245,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Other short-term interest-bearing securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Equity securities | 0 |  | 0 |  |  |
Derivatives: |  |  |  |  |  |
Total assets | 12,843,000,000 |  | 29,968,000,000 |  |  |
Derivatives: |  |  |  |  |  |
Contingent consideration obligations | 0 |  | 0 |  |  |
Total liabilities | 665,000,000 |  | 485,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Foreign currency contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 121,000,000 |  | 6,000,000 |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 49,000,000 |  | 204,000,000 |  |  |
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 | 261,000,000 |  | 270,000,000 |  |  |
Derivatives: |  |  |  |  |  |
Foreign currency and cross-currency swap contracts | 306,000,000 |  | 220,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Interest rate swap contracts [Member] |  |  |  |  |  |
Derivatives: |  |  |  |  |  |
Interest rate contracts |  |  | 10,000,000 |  |  |
Derivatives: |  |  |  |  |  |
Interest rate swap contracts | 310,000,000 |  | 61,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | U.S. Treasury notes [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | U.S. Treasury bills [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  |  |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Other government-related debt securities - U.S. [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 109,000,000 |  | 223,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Other government-related debt securities - Foreign and other [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 1,008,000,000 |  | 2,422,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Corporate debt securities - Financial [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 2,697,000,000 |  | 10,072,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Corporate debt securities - Industrial [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 2,578,000,000 |  | 9,670,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Corporate debt securities - Other [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 573,000,000 |  | 1,390,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Residential mortgage-backed securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 1,462,000,000 |  | 2,168,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Other mortgage- and asset-backed securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 473,000,000 |  | 2,297,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Money market mutual funds [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Other short-term interest-bearing securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 3,561,000,000 |  | 1,440,000,000 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Equity securities | 0 |  | 0 |  |  |
Derivatives: |  |  |  |  |  |
Total assets | 0 |  | 0 |  |  |
Derivatives: |  |  |  |  |  |
Contingent consideration obligations | 66,000,000 | $ 72,000,000 | 69,000,000 | $ 68,000,000 | $ 182,000,000 | $ 179,000,000
Total liabilities | 66,000,000 |  | 69,000,000 |  |  |
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 |  | 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 |  |  |
Derivatives: |  |  |  |  |  |
Interest rate swap contracts | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | U.S. Treasury notes [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | U.S. Treasury bills [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  |  |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Other government-related debt securities - U.S. [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Other government-related debt securities - Foreign and other [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Corporate debt securities - Financial [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Corporate debt securities - Industrial [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Corporate debt securities - Other [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Residential mortgage-backed securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Other mortgage- and asset-backed securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Money market mutual funds [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | 0 |  | 0 |  |  |
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Other short-term interest-bearing securities [Member] |  |  |  |  |  |
Assets: |  |  |  |  |  |
Interest-bearing securities | $ 0 |  | $ 0 |  |  |

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- Definition Fair value as of the balance sheet date of all derivative assets designated as interest rate fair value hedging instruments. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 815 -SubTopic 10 -Section 50 -Paragraph 4B -Subparagraph (c)(1) -URI http://asc.fasb.org/extlink&oid=109980867&loc=SL5624163-113959 + Details
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