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Fair value measurement (Details) - USD ($)
$ in Millions
Sep. 30, 2023
Jun. 30, 2023
Dec. 31, 2022
Sep. 30, 2022
Jun. 30, 2022
Dec. 31, 2021
Assets:            
Interest-bearing securities $ 34,208   $ 4,335      
Other investments 136   130      
Equity Securities, FV-NI, Noncurrent 4,250   815      
Derivatives:            
Total assets 38,941   5,621      
Derivatives:            
Forward interest rate contracts 1,314   1,398      
Contingent consideration obligations 98 $ 248 270 $ 302 $ 310 $ 342
Total liabilities 1,412   1,668      
Foreign currency forward contracts            
Derivatives:            
Foreign currency and cross-currency swap contracts 347   287      
Derivatives:            
Foreign currency and cross-currency swap contracts 29   76      
Cross-currency swap contracts            
Derivatives:            
Foreign currency and cross-currency swap contracts 0   54      
Derivatives:            
Foreign currency and cross-currency swap contracts 513   541      
Interest rate swap contracts            
Derivatives:            
Interest rate swap contracts 772   776      
Forward interest rate contracts            
Derivatives:            
Forward interest rate contracts 0   5      
Quoted prices in active markets  for identical assets (Level 1)            
Assets:            
Other investments 0   0      
Equity Securities, FV-NI, Noncurrent 4,250   480      
Derivatives:            
Total assets 38,458   4,815      
Derivatives:            
Contingent consideration obligations 0   0      
Total liabilities 0   0      
Quoted prices in active markets  for identical assets (Level 1) | Foreign currency forward contracts            
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) | Cross-currency swap contracts            
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) | Interest rate swap contracts            
Derivatives:            
Interest rate swap contracts 0   0      
Quoted prices in active markets  for identical assets (Level 1) | Forward interest rate contracts            
Derivatives:            
Forward interest rate contracts 0   0      
Significant other observable inputs (Level 2)            
Assets:            
Other investments 136   130      
Equity Securities, FV-NI, Noncurrent 0   0      
Derivatives:            
Total assets 483   471      
Derivatives:            
Contingent consideration obligations 0   0      
Total liabilities 1,314   1,398      
Significant other observable inputs (Level 2) | Foreign currency forward contracts            
Derivatives:            
Foreign currency and cross-currency swap contracts 347   287      
Derivatives:            
Foreign currency and cross-currency swap contracts 29   76      
Significant other observable inputs (Level 2) | Cross-currency swap contracts            
Derivatives:            
Foreign currency and cross-currency swap contracts 0   54      
Derivatives:            
Foreign currency and cross-currency swap contracts 513   541      
Significant other observable inputs (Level 2) | Interest rate swap contracts            
Derivatives:            
Interest rate swap contracts 772   776      
Significant other observable inputs (Level 2) | Forward interest rate contracts            
Derivatives:            
Forward interest rate contracts 0   5      
Significant unobservable inputs (Level 3)            
Assets:            
Other investments 0   0      
Equity Securities, FV-NI, Noncurrent 0   335      
Derivatives:            
Total assets 0   335      
Derivatives:            
Contingent consideration obligations 98   270      
Total liabilities 98   270      
Significant unobservable inputs (Level 3) | Foreign currency forward contracts            
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) | Cross-currency swap contracts            
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) | Interest rate swap contracts            
Derivatives:            
Interest rate swap contracts 0   0      
Significant unobservable inputs (Level 3) | Forward interest rate contracts            
Derivatives:            
Forward interest rate contracts 0   0      
U.S. Treasury bills            
Assets:            
Interest-bearing securities 0   1,676      
U.S. Treasury bills | Quoted prices in active markets  for identical assets (Level 1)            
Assets:            
Interest-bearing securities 0   1,676      
U.S. Treasury bills | Significant other observable inputs (Level 2)            
Assets:            
Interest-bearing securities 0   0      
U.S. Treasury bills | Significant unobservable inputs (Level 3)            
Assets:            
Interest-bearing securities 0   0      
Money market mutual funds            
Assets:            
Interest-bearing securities 34,208   2,659      
Money market mutual funds | Quoted prices in active markets  for identical assets (Level 1)            
Assets:            
Interest-bearing securities 34,208   2,659      
Money market mutual funds | Significant other observable inputs (Level 2)            
Assets:            
Interest-bearing securities 0   0      
Money market mutual funds | Significant unobservable inputs (Level 3)            
Assets:            
Interest-bearing securities $ 0   $ 0