BOSTON -- With only a week to go before Massachusetts voters head to the polls to choose the two candidates who will vie for Sen. Ted Kennedy's Senate seat in a special January election, the four Democratic contenders squared off in a televised debate Tuesday, engaging in a heated exchange over health care reform and abortion rights.

The debate was sponsored by WCVB-TV and GateHouse Media New England and WickedLocal.com. The two Republican contenders, state Sen.Scott Brown and Jack E. Robinson both rejected invitations to participate in a debate.

As the debate began, the contenders were asked where they stand on Afghanistan, a subject that was top of mind in Washington as President Barack Obama prepared to discuss his plan for sending more troops to the region.

Every candidate expressed opposition to U.S. troop increases, saying the Kharzei government is corrupt and more forces on the ground won't do anything to advance American interests in the region or counter terrorism.

"I'm very skeptical that more troops are the answer," said Boston Celtics co-owner Stephen Pagliuca. "Nation building doesn't work at that distance."

He said America should focus its efforts on counter-terrorism instead, but said that he will listen to Obama's strategy with an open mind.

"I'm upset by the deployment of 30,000 more troops and an 18-month exit strategy," said Attorney General Martha Coakley, saying she strongly disapproves of more U.S. involvement in Afghanistan and doesn't believe Obama's strategy for training Afghan troops and stabilizing the region "can be accomplished in that period of time."

"We don't need more troops. We need a timetable to transfer to Afghan armed forces and focus on terrorists in Pakistan," said City Year co-founder Alan Khazei.

"There's no reason for us to be there," said U.S. Rep. Michael Capuano. "We can't stop the Afghans from being corrupt." He said the U.S. needs to focus on fighting al-Qaida terrorists who have moved to Pakistan instead.

Capuano was the first to gingerly try to take the gloves off when the four candidates were asked how they stood on the Patriot Act and a possible extension of it.

All were asked to give short yes or no answers as to whether they supported it. While Khazei, Pagliuca and Capuano all said they were against it, Coakley, long considered the front-runner in the race, said she was in favor of "building in civil liberties and protections," saying she believed there "is a way to structure a Patriot Act that protects the public."

"The Patriot Act takes away civil liberties, unequivocally," Capuano said. "It was a huge mistake and a terrible blemish, and we have to rectify it as soon as possible."

The real sparks flew, however, in exchanges between Coakley and Pagliuca when they sparred over the issue of health care reform.

"Two of the candidates in this race are not reliable votes," Pagliuca said, referring to Coakley and Capuano. "They're not going to vote for the health care bill. They have stipulations. I don't have any stipulations. Both these bills are good."

Coakley responded by saying she believes in a goal of getting everyone insured but was interrupted by Pagliuca.

"Martha, you're on record that you would not vote for the House bill," he said. "OK, it's a yes or no thing."

"If the House bill is the one that comes out, I would vote for it, because I want 30 million people covered," Pagliuca said.

"Well, I would not, because I don't believe we need to compromise women's rights to do that," Coakley responded, alluding to provisions in the bill that would limit access to abortions.

Pagliuca answered by saying that passing the bill would protect women's rights by providing insurance to 30 million uninsured Americans, and he added that he was pro choice.

"Steve, it's personal with me," Coakley said tersely. "And it's personal for every woman who's in this, who's watching this. This was an amendment that was a poison pill."

"It's personal with me too ... because we have 45,000 people dying because they have no access to insurance," Pagliuca said.

"It doesn't have to be a choice, because it's a false choice," Coakley said. "We can get it passed without compromising rights."

Capuano jumped in and said he stood by his vote in support of the House health care bill, but he said he won't support legislation going forward just because it carries the health care reform label.

"If the health care reform bill comes through (the Senate) and it is a bad bill, I will vote no," he said. "It may be a bad public option, it might be women's right to choose ... there are any number of reasons to vote no. We're not there yet."

Capuano then picked up steam and went after Pagliuca, adding that House Speaker Nancy Pelosi promised reproductive rights funding would not be an issue in any final bill in any case.

"And by the way, Mr. Pagliuca, I would ask you one question. Have you ever known a poor woman who was forced to choose for an abortion without health care coverage? Have you ever known one?"

"Yes, I have," Pagliuca said.

"So have I. And you would send them back to the alleys of America?" Capuano said.

"I would not send them back to the alleys," Pagliuca said.

"Apparently you would. And that's your choice and you're entitled to make that, but you are wrong in that, Mr. Pagliuca. Poor women don't deserve to be treated that way, and I'm sorry you feel that way," Capuano said, raising his voice and pointing his finger.

"That's a personal attack," Pagliuca said. "That's politics ... you don't want to talk about the issues; you want to do the personal attacks."

Khazei tried to strike a more conciliatory note by saying "We're all pro choice and we all want universal health care ... We're arguing among ourselves."

They all acknowledged, however, that Massachusetts' health care plan has not saved state residents any money, with the commonwealth's health care costs some of the highest in the nation.

"We need to reform the whole system," Khazei said. "We need to have a strong public option, so we have competition. We need to repeal the anti-trust exemption, which has been put in there by the health care lobbyists. There are six health care lobbyists for every member of Congress."

The candidates were quizzed on a variety of other issues, including whether gambling in Massachusetts was a legal or moral issue.

"I am concerned," Khazei said, saying gambling increases crime, addiction and bankruptcies. "Casinos prey on the most vulnerable in society."

All said they would support spending $20 million in public money for the Kennedy Senate Institute.

Khazei, however, said he didn't support the way the money was tacked on to a defense appropriation bill.

"Look, everybody loved Sen. Kennedy in the Congress. If we had made this as an up or down vote in the Congress, they would have supported it," he said.

Asked what three specific things they would do to generate jobs, all mentioned programs such as tax credits for businesses and more aid to cities and towns.

Capuano said the solution was more stimulus money. "Quick, deep, massive directed federal programs to get companies to hire more people," he said, acknowledging that such programs would primarily benefit construction industries.

Pagliuca said the answer was to invest in the "jobs of the future," such as those generated by biotech and life sciences companies. He also said the government should invest as much money on job training as it has been spending on unemployment.

Coakley said private businesses "can't get credit," because banks are "sitting on money," and that needs to be rectified. She said money needs to be targeted to the regions that need it most.

In closing statements, each candidate had an opportunity to underscore the unique image they've crafted for themselves in the race. Capuano reiterated his campaign theme that he is the man to replace Kennedy and carry on his work in the Senate, while Khazei remained soft-spoken and asked for voters' "hearts, hands and vote."

Pagliuca maintained his stance as the successful business entrepreneur who would not be influenced by special interests in Washington, while Coakley fashioned herself as "a different kind of leader," whose focus would be on turning the economy around and "getting our people back to work here."

The primary is Dec. 8. The special election is Jan. 19.