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Fair value measurement (Details) - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Assets:
Interest-bearing securities	$ 20,227	$ 28,724
Equity securities	277	176
Derivatives:
Total assets	21,209	29,308
Derivatives:
Contingent consideration obligations	62	72
Total liabilities	546	648
Foreign currency contracts [Member]
Derivatives:
Foreign currency and cross-currency swap contracts	339	182
Derivatives:
Foreign currency and cross-currency swap contracts	6	26
Cross-currency swap contracts [Member]
Derivatives:
Foreign currency and cross-currency swap contracts	12	170
Derivatives:
Foreign currency and cross-currency swap contracts	478	401
Interest rate swap contracts [Member]
Derivatives:
Interest rate swap contracts	354	56
Derivatives:
Interest rate swap contracts		149
Quoted prices in active markets for identical assets (Level 1) [Member]
Assets:
Equity securities	277	176
Derivatives:
Total assets	11,955	16,689
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
Significant other observable inputs (Level 2) [Member]
Assets:
Equity securities	0	0
Derivatives:
Total assets	9,254	12,619
Derivatives:
Contingent consideration obligations	0	0
Total liabilities	484	576
Significant other observable inputs (Level 2) [Member] | Foreign currency contracts [Member]
Derivatives:
Foreign currency and cross-currency swap contracts	339	182
Derivatives:
Foreign currency and cross-currency swap contracts	6	26
Significant other observable inputs (Level 2) [Member] | Cross-currency swap contracts [Member]
Derivatives:
Foreign currency and cross-currency swap contracts	12	170
Derivatives:
Foreign currency and cross-currency swap contracts	478	401
Significant other observable inputs (Level 2) [Member] | Interest rate swap contracts [Member]
Derivatives:
Interest rate swap contracts	354	56
Derivatives:
Interest rate swap contracts		149
Significant unobservable inputs (Level 3) [Member]
Assets:
Equity securities	0	0
Derivatives:
Total assets	0	0
Derivatives:
Contingent consideration obligations	62	72
Total liabilities	62	72
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
U.S. Treasury notes [Member]
Assets:
Interest-bearing securities	1,167	2,663
U.S. Treasury notes [Member] | Quoted prices in active markets for identical assets (Level 1) [Member]
Assets:
Interest-bearing securities	1,167	2,663
U.S. Treasury notes [Member] | Significant other observable inputs (Level 2) [Member]
Assets:
Interest-bearing securities	0	0
U.S. Treasury notes [Member] | Significant unobservable inputs (Level 3) [Member]
Assets:
Interest-bearing securities	0	0
U.S. Treasury bills [Member]
Assets:
Interest-bearing securities	2,494	8,191
U.S. Treasury bills [Member] | Quoted prices in active markets for identical assets (Level 1) [Member]
Assets:
Interest-bearing securities	2,494	8,191
U.S. Treasury bills [Member] | Significant other observable inputs (Level 2) [Member]
Assets:
Interest-bearing securities	0	0
U.S. Treasury bills [Member] | Significant unobservable inputs (Level 3) [Member]
Assets:
Interest-bearing securities	0	0
Other government-related debt securities - U.S. [Member]
Assets:
Interest-bearing securities	0	110
Other government-related debt securities - U.S. [Member] | Quoted prices in active markets for identical assets (Level 1) [Member]
Assets:
Interest-bearing securities	0	0
Other government-related debt securities - U.S. [Member] | Significant other observable inputs (Level 2) [Member]
Assets:
Interest-bearing securities	0	110
Other government-related debt securities - U.S. [Member] | Significant unobservable inputs (Level 3) [Member]
Assets:
Interest-bearing securities	0	0
Other government-related debt securities - Foreign and other [Member]
Assets:
Interest-bearing securities	925	932
Other government-related debt securities - Foreign and other [Member] | Quoted prices in active markets for identical assets (Level 1) [Member]
Assets:
Interest-bearing securities	0	0
Other government-related debt securities - Foreign and other [Member] | Significant other observable inputs (Level 2) [Member]
Assets:
Interest-bearing securities	925	932
Other government-related debt securities - Foreign and other [Member] | Significant unobservable inputs (Level 3) [Member]
Assets:
Interest-bearing securities	0	0
Corporate debt securities - Financial [Member]
Assets:
Interest-bearing securities	2,140	2,697
Corporate debt securities - Financial [Member] | Quoted prices in active markets for identical assets (Level 1) [Member]
Assets:
Interest-bearing securities	0	0
Corporate debt securities - Financial [Member] | Significant other observable inputs (Level 2) [Member]
Assets:
Interest-bearing securities	2,140	2,697
Corporate debt securities - Financial [Member] | Significant unobservable inputs (Level 3) [Member]
Assets:
Interest-bearing securities	0	0
Corporate debt securities - Industrial [Member]
Assets:
Interest-bearing securities	2,025	2,504
Corporate debt securities - Industrial [Member] | Quoted prices in active markets for identical assets (Level 1) [Member]
Assets:
Interest-bearing securities	0	0
Corporate debt securities - Industrial [Member] | Significant other observable inputs (Level 2) [Member]
Assets:
Interest-bearing securities	2,025	2,504
Corporate debt securities - Industrial [Member] | Significant unobservable inputs (Level 3) [Member]
Assets:
Interest-bearing securities	0	0
Corporate debt securities - Other [Member]
Assets:
Interest-bearing securities	537	562
Corporate debt securities - Other [Member] | Quoted prices in active markets for identical assets (Level 1) [Member]
Assets:
Interest-bearing securities	0	0
Corporate debt securities - Other [Member] | Significant other observable inputs (Level 2) [Member]
Assets:
Interest-bearing securities	537	562
Corporate debt securities - Other [Member] | Significant unobservable inputs (Level 3) [Member]
Assets:
Interest-bearing securities	0	0
Residential mortgage-backed securities [Member]
Assets:
Interest-bearing securities	516	1,422
Residential mortgage-backed securities [Member] | Quoted prices in active markets for identical assets (Level 1) [Member]
Assets:
Interest-bearing securities	0	0
Residential mortgage-backed securities [Member] | Significant other observable inputs (Level 2) [Member]
Assets:
Interest-bearing securities	516	1,422
Residential mortgage-backed securities [Member] | Significant unobservable inputs (Level 3) [Member]
Assets:
Interest-bearing securities	0	0
Other mortgage- and asset-backed securities [Member]
Assets:
Interest-bearing securities	43	469
Other mortgage- and asset-backed securities [Member] | Quoted prices in active markets for identical assets (Level 1) [Member]
Assets:
Interest-bearing securities	0	0
Other mortgage- and asset-backed securities [Member] | Significant other observable inputs (Level 2) [Member]
Assets:
Interest-bearing securities	43	469
Other mortgage- and asset-backed securities [Member] | Significant unobservable inputs (Level 3) [Member]
Assets:
Interest-bearing securities	0	0
Money market mutual funds [Member]
Assets:
Interest-bearing securities	8,017	5,659
Money market mutual funds [Member] | Quoted prices in active markets for identical assets (Level 1) [Member]
Assets:
Interest-bearing securities	8,017	5,659
Money market mutual funds [Member] | Significant other observable inputs (Level 2) [Member]
Assets:
Interest-bearing securities	0	0
Money market mutual funds [Member] | Significant unobservable inputs (Level 3) [Member]
Assets:
Interest-bearing securities	0	0
Other short-term interest-bearing securities [Member]
Assets:
Interest-bearing securities	2,363	3,515
Other short-term interest-bearing securities [Member] | Quoted prices in active markets for identical assets (Level 1) [Member]
Assets:
Interest-bearing securities	0	0
Other short-term interest-bearing securities [Member] | Significant other observable inputs (Level 2) [Member]
Assets:
Interest-bearing securities	2,363	3,515
Other short-term interest-bearing securities [Member] | Significant unobservable inputs (Level 3) [Member]
Assets:
Interest-bearing securities	$ 0	$ 0

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