Things have changed since Barack Obama outlined his health care plan in Iowa in 2007 -- and not just the fact that Obama is president and just signed a new health care into law.

Three years ago, aides estimated the cost of Obama's health care plan at $50 billion to $65 billion; the plan Obama signed into law this week is projected at $938 billion over 10 years.

In 2007, Obama said, "If you are one of the 45 million Americans who don't have health insurance, you will have it after this plan becomes law." The new law won't cover about 23 million people.

During the campaign, Obama opposed a requirement that all Americans buy insurance or face fines. He changed his position as president, and this bill has a mandate.

There are many similarities between what Obama said in 2007 and what is now law. Then and now, Obama spoke of how rising insurance rates were bankrupting people and businesses and of the waste and inefficiencies within the health care system. He pledged to block insurance providers from denying coverage to people with pre-existing conditions.

The Obama of 2007 cited historic health care efforts. He spoke of how President Lyndon Johnson signed the Medicare bill at the home of ex-president Harry Truman, who had fought unsuccessfully for a health care bill of his own.

In 2007, Obama said, "Never forget that we have it within our power to shape history in this country. It is not in our character to sit idly by as victims of fate or circumstance, for we are a people of action and innovation, forever pushing the boundaries of what's possible."

Tuesday, just before signing the health care bill, President Obama said, "We are a nation that does what is hard. What is necessary. What is right. Here, in this country, we shape our own destiny. That is what we do. That is who we are."

(Posted by David Jackson)