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Acquisitions and other investments - Schedule of Purchase Price Allocation and Identifiable Assets Acquired and Liabilities Assumed - Shields (Details) - USD ($) $ in Millions	Oct. 29, 2021	May 31, 2023	Aug. 31, 2022
Identifiable assets acquired and liabilities assumed:
Goodwill		$ 28,371	$ 22,280
Shields Health Solutions Parent, LLC
Purchase Price Allocation:
Cash consideration	$ 969
Fair value of equity consideration	13
Fair value of previously held equity interests	502
Fair value of non-controlling interests	589
Total	2,074
Identifiable assets acquired and liabilities assumed:
Tangible assets	84
Intangible assets	1,060
Liabilities	(600)
Total identifiable net assets	544
Goodwill	$ 1,529