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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
9 Months Ended
Sep. 30, 2019
Sep. 30, 2018
Operating Activities    
Net income including noncontrolling interests $ 1,845 $ 1,915
Adjustments to reconcile net income including noncontrolling interests to net cash provided by operations:    
Depreciation and amortization 386 385
Restructuring and termination benefits, net of cash 11 (20)
Stock-based compensation expense 83 97
Charge for U.S. tax reform 0 80
Deferred income taxes 79 78
Voluntary benefit plan contributions (113) (67)
Cash effects of changes in:    
Receivables (65) (196)
Inventories (69) (36)
Accounts payable and other accruals (52) 13
Other non-current assets and liabilities 58 (55)
Net cash provided by operations 2,163 2,194
Investing Activities    
Capital expenditures (226) (321)
Purchases of marketable securities and investments (152) (159)
Proceeds from sale of marketable securities and investments 14 28
Payment for acquisitions, net of cash acquired (1,711) (728)
Other 0 6
Net cash used in investing activities (2,075) (1,174)
Financing Activities    
Principal payments on debt (4,184) (5,478)
Proceeds from issuance of debt 6,008 5,536
Dividends paid (1,140) (1,122)
Purchases of treasury shares (1,024) (956)
Proceeds from exercise of stock options 490 319
Net cash provided by (used in) financing activities 150 (1,701)
Effect of exchange rate changes on Cash and cash equivalents (16) (13)
Net increase (decrease) in Cash and cash equivalents 222 (694)
Cash and cash equivalents at beginning of the period 726 1,535
Cash and cash equivalents at end of the period 948 841
Supplemental Cash Flow Information    
Income taxes paid $ 669 $ 655