It's possible to read too much into any particular speech, campaign rally or debating point, but I think the contrast between what Obama is saying here and what Hillary is saying here is significant.
What I think Obama is saying here is basically that the kind of change the country needs and is capable of, and which Obama believes he can help deliver, is a comprehensive change built on the back of a new coalition, and built through a process of the nation's leaders appealing over the heads of lobbyists and entrenched interests in Congress to that of the nation's. It is a form of this argument.
Hillary's argument is a more of an insider's being able to game the system.
These arguments are not necessarily mutually exclusive, particularly as it may concern any one policy area (like health care). But this a sense where I think Obama and Hillary are talking past one another. Obama's theory of change is more far-reaching, more comprehensive, and in some ways, perhaps not fully fleshed out, yet open to the future (i.e. more visionary), where Hillary's is more of the policy white paper variety of change, mechanical, not inspirational, rhetorical or worldview encompassing. That I think is the crux of the difference between them and why, at least in the case of Iowa, Obama was able to expand the caucus turnout and win the state.