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Fair value measurements - Summary of assets and liabilities recorded at fair value (Details) - USD ($) $ in Millions | Dec. 31, 2017 | Dec. 31, 2016
--- | --- | ---
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | $ 34,301 |
Estimate of Fair Value Measurement [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Available-for-sale Securities, Equity Securities | 635 | $ 428
Deferred compensation plan | 116 | 84
Foreign currency derivative contracts | 13 | 336
Fair Value Assets, total | 35,065 | 30,711
Deferred compensation plan | 116 | 84
Foreign currency derivative contracts | 93 | 37
Contingent consideration | 15 | 25
Fair Value Liabilities, total | 224 | 146
Fair Value, Inputs, Level 1 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Available-for-sale Securities, Equity Securities | 635 | 428
Deferred compensation plan | 116 | 84
Foreign currency derivative contracts | 0 | 0
Fair Value Assets, total | 9,526 | 11,505
Deferred compensation plan | 116 | 84
Foreign currency derivative contracts | 0 | 0
Contingent consideration | 0 | 0
Fair Value Liabilities, total | 116 | 84
Fair Value, Inputs, Level 2 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Available-for-sale Securities, Equity Securities |  | 0
Deferred compensation plan | 0 | 0
Foreign currency derivative contracts | 13 | 336
Fair Value Assets, total | 25,539 | 19,206
Deferred compensation plan | 0 | 0
Foreign currency derivative contracts | 93 | 37
Contingent consideration | 0 | 0
Fair Value Liabilities, total | 93 | 37
Fair Value, Inputs, Level 3 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Available-for-sale Securities, Equity Securities | 0 | 0
Deferred compensation plan | 0 | 0
Foreign currency derivative contracts | 0 | 0
Fair Value Assets, total | 0 | 0
Deferred compensation plan | 0 | 0
Foreign currency derivative contracts | 0 | 0
Contingent consideration | 15 | 25
Fair Value Liabilities, total | 15 | 25
Corporate debt securities | Estimate of Fair Value Measurement [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 14,747 | 12,603
Corporate debt securities | Fair Value, Inputs, Level 1 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 0
Corporate debt securities | Fair Value, Inputs, Level 2 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 14,747 | 12,603
Corporate debt securities | Fair Value, Inputs, Level 3 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 0
Certificates of deposit | Estimate of Fair Value Measurement [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 5,131 | 943
Certificates of deposit | Fair Value, Inputs, Level 1 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 0
Certificates of deposit | Fair Value, Inputs, Level 2 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 5,131 | 943
Certificates of deposit | Fair Value, Inputs, Level 3 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 0
Money market funds | Estimate of Fair Value Measurement [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 4,714 | 5,464
Money market funds | Fair Value, Inputs, Level 1 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 4,714 | 5,464
Money market funds | Fair Value, Inputs, Level 2 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 0
Money market funds | Fair Value, Inputs, Level 3 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 0
U.S. treasury securities | Estimate of Fair Value Measurement [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 4,061 | 5,529
U.S. treasury securities | Fair Value, Inputs, Level 1 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 4,061 | 5,529
U.S. treasury securities | Fair Value, Inputs, Level 2 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 0
U.S. treasury securities | Fair Value, Inputs, Level 3 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 0
Residential mortgage and asset-backed securities | Estimate of Fair Value Measurement [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 4,058 | 3,602
Residential mortgage and asset-backed securities | Fair Value, Inputs, Level 1 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 0
Residential mortgage and asset-backed securities | Fair Value, Inputs, Level 2 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 4,058 | 3,602
Residential mortgage and asset-backed securities | Fair Value, Inputs, Level 3 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 0
U.S. government agencies securities | Estimate of Fair Value Measurement [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 926 | 975
U.S. government agencies securities | Fair Value, Inputs, Level 1 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 0
U.S. government agencies securities | Fair Value, Inputs, Level 2 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 926 | 975
U.S. government agencies securities | Fair Value, Inputs, Level 3 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 0
Non-U.S. government securities | Estimate of Fair Value Measurement [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 664 | 720
Non-U.S. government securities | Fair Value, Inputs, Level 1 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 0
Non-U.S. government securities | Fair Value, Inputs, Level 2 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 664 | 720
Non-U.S. government securities | Fair Value, Inputs, Level 3 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 0
Municipal debt securities | Estimate of Fair Value Measurement [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 27
Municipal debt securities | Fair Value, Inputs, Level 1 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 0
Municipal debt securities | Fair Value, Inputs, Level 2 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | 0 | 27
Municipal debt securities | Fair Value, Inputs, Level 3 [Member] |  |
Fair Value, Assets and Liabilities Measured on Recurring Basis |  |
Debt Securities, Fair Value | $ 0 | $ 0

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