Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Operating cash flows:
Net income before non-controlling interests	$ 2,367	$ 1,667
Adjustments to reconcile net income used for operations:
Depreciation and amortization of fixed assets and capitalized software	291	282
Amortization of intangible assets	278	265
Non cash lease expense	241	241
Adjustments and payments related to contingent consideration assets and liabilities	(16)	(14)
Provision for deferred income taxes	7	6
Net (gain) loss on investments	(43)	47
Net (gain) loss on disposition of assets	(37)	9
Share-based compensation expense	263	219
Changes in assets and liabilities:
Net receivables	(336)	77
Other current assets	(114)	(14)
Other assets	(115)	69
Accounts payable and accrued liabilities	(66)	(144)
Accrued compensation and employee benefits	(53)	(431)
Accrued income taxes	92	150
Contributions to pension and other benefit plans in excess of current year credit	(282)	(240)
Other liabilities	(96)	74
Operating lease liabilities	(262)	(254)
Effect of exchange rate changes	(45)	(10)
Net cash provided by operations	2,074	1,999
Financing cash flows:
Purchase of treasury shares	(734)	0
Borrowings from term-loan and credit facilities	0	1,000
Proceeds from issuance of debt	0	737
Repayments of debt	(512)	(1,011)
Purchase of non-controlling interests	0	(3)
Shares withheld for taxes on vested units – treasury shares	(99)	(131)
Issuance of common stock from treasury shares	115	98
Payments of deferred and contingent consideration for acquisitions	(110)	(125)
Receipts of contingent consideration for dispositions	71	0
Distributions of non-controlling interests	(27)	(26)
Dividends paid	(750)	(702)
Net cash used for financing activities	(2,046)	(163)
Investing cash flows:
Capital expenditures	(268)	(278)
Net sale of long term investments	2	102
Dispositions	84	93
Acquisitions	(401)	(559)
Other, net	(6)	(4)
Net cash used for investing activities	(589)	(646)
Effect of exchange rate changes on cash and cash equivalents	(130)	43
(Decrease) increase in cash and cash equivalents	(691)	1,233
Cash and cash equivalents at beginning of period	2,089	1,155
Cash and cash equivalents at end of period	$ 1,398	$ 2,388