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Derivative instruments Derivative instruments (Summary of Income and Expense Line Items) (Details) - USD ($) $ in Millions | 3 Months Ended | 12 Months Ended
--- | --- | ---
Dec. 31, 2018 | Sep. 30, 2018 | Jun. 30, 2018 | Mar. 31, 2018 | Dec. 31, 2017 | Sep. 30, 2017 | Jun. 30, 2017 | Mar. 31, 2017 | Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Derivative [Line Items] |  |  |  |  |  |  |  |  |  |  |
Interest and other income, net |  |  |  |  |  |  |  |  | $ 674 | $ 928 | $ 629
Interest expense, net |  |  |  |  |  |  |  |  | (1,392) | (1,304) | (1,260)
Amortization of cumulative amount of fair value hedging adjustments for discontinued hedging relationships |  |  |  |  |  |  |  |  | 23 |  |
Interest rate swap agreements [Member] |  |  |  |  |  |  |  |  |  |  |
Derivative [Line Items] |  |  |  |  |  |  |  |  |  |  |
Gains (losses) on fair value hedging relationships, Hedged Items |  |  |  |  |  |  |  |  | 65 |  |
Gains (losses) on fair value hedging relationships, Derivatives designated as hedging instruments |  |  |  |  |  |  |  |  | (42) |  |
Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedges [Member] | Cross-currency swap contracts [Member] |  |  |  |  |  |  |  |  |  |  |
Derivative [Line Items] |  |  |  |  |  |  |  |  |  |  |
Interest and other income, net |  |  |  |  |  |  |  |  | (241) |  |
Product sales [Member] |  |  |  |  |  |  |  |  |  |  |
Derivative [Line Items] |  |  |  |  |  |  |  |  |  |  |
Product sales | $ 6,001 | $ 5,510 | $ 5,679 | $ 5,343 | $ 5,569 | $ 5,453 | $ 5,574 | $ 5,199 | 22,533 | $ 21,795 | $ 21,892
Product sales [Member] | Reclassification out of Accumulated Other Comprehensive Income [Member] | Cash flow hedges [Member] | Foreign currency contracts [Member] |  |  |  |  |  |  |  |  |  |  |
Derivative [Line Items] |  |  |  |  |  |  |  |  |  |  |
Product sales |  |  |  |  |  |  |  |  | $ (21) |  |

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