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Stock Compensation - Exercise Price Range (Details) - Employee Stock Option - Long-term incentive and director compensation plans - $ / shares
12 Months Ended
Dec. 31, 2018
Dec. 31, 2017
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]    
Exercise Price Range, Minimum $ 14.47  
Exercise Price Range, Maximum $ 113.30  
Number Outstanding (Shares) 39,905,454 44,754,593
Weighted Average Remaining Contractual Life (Years) 5 years 10 months 24 days  
Options Outstanding Weighted Average Exercise Price per Share $ 56.10 $ 48.49
Number Exercisable (Shares) 23,625,802  
Options Exercisable Weighted Average Exercise Price per Share $ 42.76  
Range Of Exercise Prices $14.47 to $20.00    
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]    
Exercise Price Range, Minimum 14.47  
Exercise Price Range, Maximum $ 20.00  
Number Outstanding (Shares) 573,629  
Weighted Average Remaining Contractual Life (Years) 1 month 6 days  
Options Outstanding Weighted Average Exercise Price per Share $ 14.96  
Number Exercisable (Shares) 573,629  
Options Exercisable Weighted Average Exercise Price per Share $ 14.96  
Range Of Exercise Prices $20.01 to $40.00    
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]    
Exercise Price Range, Minimum 20.01  
Exercise Price Range, Maximum $ 40.00  
Number Outstanding (Shares) 9,508,056  
Weighted Average Remaining Contractual Life (Years) 2 years 10 months 24 days  
Options Outstanding Weighted Average Exercise Price per Share $ 31.21  
Number Exercisable (Shares) 9,508,056  
Options Exercisable Weighted Average Exercise Price per Share $ 31.21  
Range Of Exercise Prices $40.01 to $60.00    
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]    
Exercise Price Range, Minimum 40.01  
Exercise Price Range, Maximum $ 60.00  
Number Outstanding (Shares) 19,883,804  
Weighted Average Remaining Contractual Life (Years) 6 years 2 months 12 days  
Options Outstanding Weighted Average Exercise Price per Share $ 50.95  
Number Exercisable (Shares) 12,397,285  
Options Exercisable Weighted Average Exercise Price per Share $ 49.53  
Range Of Exercise Prices $60.01 to $80.00    
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]    
Exercise Price Range, Minimum 60.01  
Exercise Price Range, Maximum $ 80.00  
Number Outstanding (Shares) 5,612,386  
Weighted Average Remaining Contractual Life (Years) 8 years 1 month 6 days  
Options Outstanding Weighted Average Exercise Price per Share $ 79.21  
Number Exercisable (Shares) 1,143,118  
Options Exercisable Weighted Average Exercise Price per Share $ 79.20  
Range Of Exercise Prices $80.01 to $100.00    
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]    
Exercise Price Range, Minimum 80.01  
Exercise Price Range, Maximum $ 100.00  
Number Outstanding (Shares) 37,917  
Weighted Average Remaining Contractual Life (Years) 9 years 3 months 18 days  
Options Outstanding Weighted Average Exercise Price per Share $ 91.16  
Number Exercisable (Shares) 3,714  
Options Exercisable Weighted Average Exercise Price per Share $ 91.54  
Range Of Exercise Prices $100.01 to $113.30    
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]    
Exercise Price Range, Minimum 100.01  
Exercise Price Range, Maximum $ 113.30  
Number Outstanding (Shares) 4,289,662  
Weighted Average Remaining Contractual Life (Years) 9 years 1 month 6 days  
Options Outstanding Weighted Average Exercise Price per Share $ 110.15  
Number Exercisable (Shares) 0  
Options Exercisable Weighted Average Exercise Price per Share $ 0