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Fair value measurement (Fair Value of Financial Assets and Liabilities on Recurring Basis) (Details) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Assets:
Interest-bearing securities	$ 28,724	$ 41,169
Equity securities	176	149
Derivatives:
Total assets	29,308	41,604
Derivatives:
Contingent consideration obligations	72	69
Total liabilities	648	554
Foreign currency contracts [Member]
Derivatives:
Foreign currency and cross-currency swap contracts	182	6
Derivatives:
Foreign currency and cross-currency swap contracts	26	204
Cross-currency swap contracts [Member]
Derivatives:
Foreign currency and cross-currency swap contracts	170	270
Derivatives:
Foreign currency and cross-currency swap contracts	401	220
Interest rate swap contracts [Member]
Derivatives:
Interest rate swap contracts	56	10
Derivatives:
Interest rate swap contracts	149	61
U.S. Treasury notes [Member]
Assets:
Interest-bearing securities	2,663	8,242
U.S. Treasury bills [Member]
Assets:
Interest-bearing securities	8,191
Other government-related debt securities - U.S. [Member]
Assets:
Interest-bearing securities	110	223
Other government-related debt securities - Foreign and other [Member]
Assets:
Interest-bearing securities	932	2,422
Corporate debt securities - Financial [Member]
Assets:
Interest-bearing securities	2,697	10,072
Corporate debt securities - Industrial [Member]
Assets:
Interest-bearing securities	2,504	9,670
Corporate debt securities - Other [Member]
Assets:
Interest-bearing securities	562	1,390
Residential mortgage-backed securities [Member]
Assets:
Interest-bearing securities	1,422	2,168
Other mortgage- and asset-backed securities [Member]
Assets:
Interest-bearing securities	469	2,297
Money market mutual funds [Member]
Assets:
Interest-bearing securities	5,659	3,245
Other short-term interest-bearing securities [Member]
Assets:
Interest-bearing securities	3,515	1,440
Quoted prices in active markets for identical assets (Level 1) [Member]
Assets:
Equity securities	176	149
Derivatives:
Total assets	16,689	11,636
Derivatives:
Contingent consideration obligations	0	0
Total liabilities	0	0
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
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
Quoted prices in active markets for identical assets (Level 1) [Member] | Interest rate swap contracts [Member]
Derivatives:
Interest rate swap contracts	0	0
Derivatives:
Interest rate swap contracts	0	0
Quoted prices in active markets for identical assets (Level 1) [Member] | U.S. Treasury notes [Member]
Assets:
Interest-bearing securities	2,663	8,242
Quoted prices in active markets for identical assets (Level 1) [Member] | U.S. Treasury bills [Member]
Assets:
Interest-bearing securities	8,191
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
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
Quoted prices in active markets for identical assets (Level 1) [Member] | Corporate debt securities - Financial [Member]
Assets:
Interest-bearing securities	0	0
Quoted prices in active markets for identical assets (Level 1) [Member] | Corporate debt securities - Industrial [Member]
Assets:
Interest-bearing securities	0	0
Quoted prices in active markets for identical assets (Level 1) [Member] | Corporate debt securities - Other [Member]
Assets:
Interest-bearing securities	0	0
Quoted prices in active markets for identical assets (Level 1) [Member] | Residential mortgage-backed securities [Member]
Assets:
Interest-bearing securities	0	0
Quoted prices in active markets for identical assets (Level 1) [Member] | Other mortgage- and asset-backed securities [Member]
Assets:
Interest-bearing securities	0	0
Quoted prices in active markets for identical assets (Level 1) [Member] | Money market mutual funds [Member]
Assets:
Interest-bearing securities	5,659	3,245
Quoted prices in active markets for identical assets (Level 1) [Member] | Other short-term interest-bearing securities [Member]
Assets:
Interest-bearing securities	0	0
Significant other observable inputs (Level 2) [Member]
Assets:
Equity securities	0	0
Derivatives:
Total assets	12,619	29,968
Derivatives:
Contingent consideration obligations	0	0
Total liabilities	576	485
Significant other observable inputs (Level 2) [Member] | Foreign currency contracts [Member]
Derivatives:
Foreign currency and cross-currency swap contracts	182	6
Derivatives:
Foreign currency and cross-currency swap contracts	26	204
Significant other observable inputs (Level 2) [Member] | Cross-currency swap contracts [Member]
Derivatives:
Foreign currency and cross-currency swap contracts	170	270
Derivatives:
Foreign currency and cross-currency swap contracts	401	220
Significant other observable inputs (Level 2) [Member] | Interest rate swap contracts [Member]
Derivatives:
Interest rate swap contracts	56	10
Derivatives:
Interest rate swap contracts	149	61
Significant other observable inputs (Level 2) [Member] | U.S. Treasury notes [Member]
Assets:
Interest-bearing securities	0	0
Significant other observable inputs (Level 2) [Member] | U.S. Treasury bills [Member]
Assets:
Interest-bearing securities	0
Significant other observable inputs (Level 2) [Member] | Other government-related debt securities - U.S. [Member]
Assets:
Interest-bearing securities	110	223
Significant other observable inputs (Level 2) [Member] | Other government-related debt securities - Foreign and other [Member]
Assets:
Interest-bearing securities	932	2,422
Significant other observable inputs (Level 2) [Member] | Corporate debt securities - Financial [Member]
Assets:
Interest-bearing securities	2,697	10,072
Significant other observable inputs (Level 2) [Member] | Corporate debt securities - Industrial [Member]
Assets:
Interest-bearing securities	2,504	9,670
Significant other observable inputs (Level 2) [Member] | Corporate debt securities - Other [Member]
Assets:
Interest-bearing securities	562	1,390
Significant other observable inputs (Level 2) [Member] | Residential mortgage-backed securities [Member]
Assets:
Interest-bearing securities	1,422	2,168
Significant other observable inputs (Level 2) [Member] | Other mortgage- and asset-backed securities [Member]
Assets:
Interest-bearing securities	469	2,297
Significant other observable inputs (Level 2) [Member] | Money market mutual funds [Member]
Assets:
Interest-bearing securities	0	0
Significant other observable inputs (Level 2) [Member] | Other short-term interest-bearing securities [Member]
Assets:
Interest-bearing securities	3,515	1,440
Significant unobservable inputs (Level 3) [Member]
Assets:
Equity securities	0	0
Derivatives:
Total assets		0
Derivatives:
Contingent consideration obligations	72	69	$ 179	$ 188
Total liabilities	72	69
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
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
Significant unobservable inputs (Level 3) [Member] | Interest rate swap contracts [Member]
Derivatives:
Interest rate swap contracts	0	0
Derivatives:
Interest rate swap contracts	0	0
Significant unobservable inputs (Level 3) [Member] | U.S. Treasury notes [Member]
Assets:
Interest-bearing securities	0	0
Significant unobservable inputs (Level 3) [Member] | U.S. Treasury bills [Member]
Assets:
Interest-bearing securities	0
Significant unobservable inputs (Level 3) [Member] | Other government-related debt securities - U.S. [Member]
Assets:
Interest-bearing securities	0	0
Significant unobservable inputs (Level 3) [Member] | Other government-related debt securities - Foreign and other [Member]
Assets:
Interest-bearing securities	0	0
Significant unobservable inputs (Level 3) [Member] | Corporate debt securities - Financial [Member]
Assets:
Interest-bearing securities	0	0
Significant unobservable inputs (Level 3) [Member] | Corporate debt securities - Industrial [Member]
Assets:
Interest-bearing securities	0	0
Significant unobservable inputs (Level 3) [Member] | Corporate debt securities - Other [Member]
Assets:
Interest-bearing securities	0	0
Significant unobservable inputs (Level 3) [Member] | Residential mortgage-backed securities [Member]
Assets:
Interest-bearing securities	0	0
Significant unobservable inputs (Level 3) [Member] | Other mortgage- and asset-backed securities [Member]
Assets:
Interest-bearing securities	0	0
Significant unobservable inputs (Level 3) [Member] | Money market mutual funds [Member]
Assets:
Interest-bearing securities	0	0
Significant unobservable inputs (Level 3) [Member] | Other short-term interest-bearing securities [Member]
Assets:
Interest-bearing securities	$ 0	$ 0

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