What a Republican NC House candidate says rural areas need from the state

To help voters learn which candidates are on their ballot and where they stand on important policy issues, The News & Observer is publishing candidate questionnaires in all state and federal races in North Carolina on the March 3, 2026, ballot.

Below are the candidates running for NC House District 48 who responded to our questionnaire, in order by the date their responses were received. Some candidates did not provide a photo.

District 48 is located in Hoke and Scotland counties and is currently represented by Rep. Garland Pierce, a Democrat who is seeking reelection.

Pierce does not have a Democratic challenger, but there is a Republican primary for the seat between Ralph Carter and Kirk Lowery.

Lowery did not respond to the questionnaire.

Ralph Carter

Age as of March 3, 2026: 72

Political party: Republican

Campaign website: RalphCarterforHouse.com

Current occupation: Orthopedic surgeon

Professional experience: I have been a board certified orthopedic surgeon since 1986 and have been practicing full-time, first four years in the U.S. Air Force, then for the past 36 years serving the North and South Carolina communities around Laurinburg, NC.

Education: My education began with 16 years of public school, through New Hanover High School, concluding at UNC-Chapel Hill where I earned a B.S. in zoology (Phi Beta Kappa). Earning a scholarship to attend from the U.S. Air Force, I graduated from Wake Forest University’s Bowman Gray School of Medicine in 1980, staying there for a five-year orthopedic residency, and completing my chief residency year in 1985.

Please list any notable government or civic involvement: At my church, in the community, and especially at Scotland Health Care System, I have held a number of positions, including chairman of surgery and of the medical staff. I now have served well over a decade as the chairman of clinical quality, and several years on its Board of Trustees. I also served several years on the Scotland County Board of Health including a year as its chairman.

What is the most important issue in your district and what do you want to do about it? Our district has suffered economic decline over about three decades due to offshoring of good jobs. Efforts have been made by local leaders to mitigate this, but we have not received our “fair share” of help. My first practical duty is to change that, to bring funding that will improve our local education system and infrastructure to support residential and industrial development, and thus better jobs to make living more affordable and enjoyable in Hoke and Scotland counties.

The legislature sets teacher base pay. What do you think the salary range should be for teachers, from starting to 30+ experience? I can enthusiastically support a starting salary of at least $50,000 for classroom teachers, with incentives for additional training and merit. I would support a steeper climb in salary above the proposed cap of around $58,000. I favor elimination of local supplements, which advantage rich counties with rich tax bases and attract teachers away from districts like ours. Teachers’ pay should be level across the state.

As of January, North Carolina was the last state not to have passed a new, comprehensive budget. What would you do to help make sure a budget passes? I do not know every nuance of conflict that prevented passing a budget, but understand there were principled disagreements that created an impasse. From what I do know, I admire the House leaders for their stand. Still, our legislature did not fulfill its duty, and that has had significant negative consequences on our citizenry. State law requires municipalities to have a budget deadline and the General Assembly should hold itself to the same standard. I would support legislation to require it.

North Carolina’s income tax rate for individual taxpayers is 3.99%. Should that be reduced further? I fully support reducing state income tax to zero in a stepwise logical fashion as our state economy allows. I would favor a shift to a consumption tax over all other forms of taxation.

Do you think the state is using taxpayer money efficiently? Why or why not? In general, governments are not efficient in use of resources, and is that the nature of government. Corruption through favoritism, bias and sometimes intentional lack of oversight, lead not only to waste, but fraud. Revelations in this regard coming out of the Department of Health and Human Services are appalling. Efficient and transparent operations, and robust, detailed oversight are needed. Corporate capture of regulatory agencies corrupts not only at the national level, but at the state level as well.

Do you support legalizing medical marijuana use? Why or why not? I support unbiased research into the potential medical uses of marijuana, and more specifically of its constituent compounds such as THC. Marijuana use can have devastating consequences especially on the developing brain, especially at concentrations of THC we now see on the street. It is not a benign drug. We need better research.

What do you see as the biggest barrier to health care access in your district, and what actions would you take to address it? The maldistribution of health care resources, especially practitioners, is the largest barrier. Doctors and systems gravitate to rich urban areas because of the increased revenue they can generate. Unchecked inflation in medical costs, with more cost thrust onto the patient every year, is also a barrier. Incentivizing relocation of practitioners, including by training them in rural areas, would help. Removing the profiteering “middlemen” and Certificate of Need restraints would help. The MAHA efforts will help.