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Republican Party candidates swapped heated accusations about health care, earmarks and federal bailouts Wednesday night in the 20th and possibly final debate of the roller-coaster race for the Republican presidential nomination.

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From the left: Ron Paul, Rick Santorum, Mitt Romney and Newt Gingrich sing the national anthem before the start of the Republican presidential debate in Mesa, Ariz., Feb. 22, 2012.Laura Segall/Reuters

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Rick Santorum speaks as Mitt Romney looks on.Johsua Lott/Reuters

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Newt Gingrich greets the crowd before the debate.Laura Segall/Reuters

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