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Fair value measurement (Details) (USD $)
In Millions, unless otherwise specified
Sep. 30, 2013
Dec. 31, 2012
Assets:    
Total available-for-sale investments $ 25,605 $ 23,745
Fair Value, Measurements, Recurring [Member]
    
Derivative Assets:    
Interest rate swap contracts 13  
Total assets 25,787 23,856
Derivative Liabilities:    
Interest rate swap contracts 97  
Contingent consideration obligations in connection with a business combination 332 221
Total liabilities 507 286
Fair Value, Measurements, Recurring [Member] | Foreign currency contracts [Member]
    
Derivative Assets:    
Foreign currency contracts 36 46
Derivative Liabilities:    
Foreign currency contracts 71 59
Fair Value, Measurements, Recurring [Member] | Cross currency swap contracts [Member]
    
Derivative Assets:    
Foreign currency contracts 133 65
Derivative Liabilities:    
Foreign currency contracts 7 6
Fair Value, Measurements, Recurring [Member] | U.S. Treasury securities [Member]
    
Assets:    
Total available-for-sale investments 6,173 4,458
Fair Value, Measurements, Recurring [Member] | Other government-related debt securities - U.S. [Member]
    
Assets:    
Total available-for-sale investments 1,122 1,030
Fair Value, Measurements, Recurring [Member] | Other government-related debt securities - Foreign and other [Member]
    
Assets:    
Total available-for-sale investments 1,208 1,608
Fair Value, Measurements, Recurring [Member] | Corporate debt securities - Financial [Member]
    
Assets:    
Total available-for-sale investments 3,460 3,361
Fair Value, Measurements, Recurring [Member] | Corporate debt securities - Industrial [Member]
    
Assets:    
Total available-for-sale investments 3,458 4,380
Fair Value, Measurements, Recurring [Member] | Corporate debt securities - Other [Member]
    
Assets:    
Total available-for-sale investments 337 452
Fair Value, Measurements, Recurring [Member] | Residential mortgage-backed securities [Member]
    
Assets:    
Total available-for-sale investments 1,397 1,829
Fair Value, Measurements, Recurring [Member] | Other mortgage- and asset-backed securities [Member]
    
Assets:    
Total available-for-sale investments 1,452 1,767
Fair Value, Measurements, Recurring [Member] | Money market mutual funds [Member]
    
Assets:    
Total available-for-sale investments 6,907 2,620
Fair Value, Measurements, Recurring [Member] | Other short-term interest-bearing securities [Member]
    
Assets:    
Total available-for-sale investments   2,186
Fair Value, Measurements, Recurring [Member] | Equity securities [Member]
    
Assets:    
Total available-for-sale investments 91 54
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member]
    
Derivative Assets:    
Interest rate swap contracts 0  
Total assets 13,171 7,132
Derivative Liabilities:    
Interest rate swap contracts 0  
Contingent consideration obligations in connection with a business combination 0 0
Total liabilities 0 0
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Foreign currency contracts [Member]
    
Derivative Assets:    
Foreign currency contracts 0 0
Derivative Liabilities:    
Foreign currency contracts 0 0
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Cross currency swap contracts [Member]
    
Derivative Assets:    
Foreign currency contracts 0 0
Derivative Liabilities:    
Foreign currency contracts 0 0
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | U.S. Treasury securities [Member]
    
Assets:    
Total available-for-sale investments 6,173 4,458
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Other government-related debt securities - U.S. [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Other government-related debt securities - Foreign and other [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Corporate debt securities - Financial [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Corporate debt securities - Industrial [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Corporate debt securities - Other [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Residential mortgage-backed securities [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Other mortgage- and asset-backed securities [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Money market mutual funds [Member]
    
Assets:    
Total available-for-sale investments 6,907 2,620
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Other short-term interest-bearing securities [Member]
    
Assets:    
Total available-for-sale investments   0
Fair Value, Measurements, Recurring [Member] | Quoted prices in active markets for identical assets (Level 1) [Member] | Equity securities [Member]
    
Assets:    
Total available-for-sale investments 91 54
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member]
    
Derivative Assets:    
Interest rate swap contracts 13  
Total assets 12,616 16,724
Derivative Liabilities:    
Interest rate swap contracts 97  
Contingent consideration obligations in connection with a business combination 0 0
Total liabilities 175 65
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Foreign currency contracts [Member]
    
Derivative Assets:    
Foreign currency contracts 36 46
Derivative Liabilities:    
Foreign currency contracts 71 59
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Cross currency swap contracts [Member]
    
Derivative Assets:    
Foreign currency contracts 133 65
Derivative Liabilities:    
Foreign currency contracts 7 6
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | U.S. Treasury securities [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Other government-related debt securities - U.S. [Member]
    
Assets:    
Total available-for-sale investments 1,122 1,030
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Other government-related debt securities - Foreign and other [Member]
    
Assets:    
Total available-for-sale investments 1,208 1,608
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Corporate debt securities - Financial [Member]
    
Assets:    
Total available-for-sale investments 3,460 3,361
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Corporate debt securities - Industrial [Member]
    
Assets:    
Total available-for-sale investments 3,458 4,380
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Corporate debt securities - Other [Member]
    
Assets:    
Total available-for-sale investments 337 452
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Residential mortgage-backed securities [Member]
    
Assets:    
Total available-for-sale investments 1,397 1,829
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Other mortgage- and asset-backed securities [Member]
    
Assets:    
Total available-for-sale investments 1,452 1,767
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Money market mutual funds [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Other short-term interest-bearing securities [Member]
    
Assets:    
Total available-for-sale investments   2,186
Fair Value, Measurements, Recurring [Member] | Significant other observable inputs (Level 2) [Member] | Equity securities [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member]
    
Derivative Assets:    
Interest rate swap contracts 0  
Total assets 0 0
Derivative Liabilities:    
Interest rate swap contracts 0  
Contingent consideration obligations in connection with a business combination 332 221
Total liabilities 332 221
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Foreign currency contracts [Member]
    
Derivative Assets:    
Foreign currency contracts 0 0
Derivative Liabilities:    
Foreign currency contracts 0 0
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Cross currency swap contracts [Member]
    
Derivative Assets:    
Foreign currency contracts 0 0
Derivative Liabilities:    
Foreign currency contracts 0 0
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | U.S. Treasury securities [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Other government-related debt securities - U.S. [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Other government-related debt securities - Foreign and other [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Corporate debt securities - Financial [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Corporate debt securities - Industrial [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Corporate debt securities - Other [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Residential mortgage-backed securities [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Other mortgage- and asset-backed securities [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Money market mutual funds [Member]
    
Assets:    
Total available-for-sale investments 0 0
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Other short-term interest-bearing securities [Member]
    
Assets:    
Total available-for-sale investments   0
Fair Value, Measurements, Recurring [Member] | Significant unobservable inputs (Level 3) [Member] | Equity securities [Member]
    
Assets:    
Total available-for-sale investments $ 0 $ 0