Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Operating cash flows:
Net income before non-controlling interests	$ 1,377	$ 1,511
Adjustments to reconcile net income to cash provided by operations:
Depreciation and amortization of fixed assets and capitalized software	245	236
Amortization of intangible assets	235	135
Non cash lease expense	236	0
Adjustments and payments related to contingent consideration liability	(9)	(10)
Charge for early extinguishment of debt	32	0
Provision for deferred income taxes	95	66
Loss (gain) on investments	(20)	24
Loss (gain) on disposition of assets	36	(53)
Share-based compensation expense	184	146
Change in fair value of acquisition-related derivative contracts	8	100
Changes in assets and liabilities:
Net receivables	(84)	(210)
Other current assets	30	19
Other assets	(59)	(51)
Accounts payable and accrued liabilities	(126)	(3)
Accrued compensation and employee benefits	(281)	(312)
Accrued income taxes	120	(13)
Contributions to pension and other benefit plans in excess of current year expense/credit	(269)	(250)
Other liabilities	(149)	11
Operating lease liabilities	(240)	0
Effect of exchange rate changes	(70)	(27)
Net cash provided by operations	1,291	1,319
Financing cash flows:
Purchase of treasury shares	(300)	(675)
Net increase in commercial paper	325	75
Net increase in short term borrowings	300	0
Proceeds from issuance of debt	6,459	592
Repayments of debt	(760)	(10)
Payment of bridge loan fees	0	(24)
Payments for early extinguishment of debt	(585)	0
Purchase of non-controlling interests	(75)	0
Acquisition-related derivative payments	(337)	0
Shares withheld for taxes on vested units – treasury shares	(89)	(62)
Issuance of common stock from treasury shares	132	72
Payments of deferred and contingent consideration for acquisitions	(60)	(106)
Distributions of non-controlling interests	(18)	(15)
Dividends paid	(655)	(594)
Net cash provided by (used for) financing activities	4,337	(747)
Investing cash flows:
Capital expenditures	(284)	(222)
Sales (purchases) of long-term investments	193	(1)
Purchase of equity investment	(91)	0
Proceeds from sales of fixed assets	4	3
Dispositions	225	5
Acquisitions	(5,500)	(536)
Other, net	(51)	(1)
Net cash used for investing activities	(5,504)	(752)
Effect of exchange rate changes on cash and cash equivalents	23	(74)
Increase (decrease) in cash and cash equivalents	147	(254)
Cash and cash equivalents at beginning of period	1,066	1,205
Cash and cash equivalents at end of period	$ 1,213	$ 951