Post-apartheid South Africa has had economic development goals aligned with that of a developmental state (DS). However, almost three decades later, persistent rates of high inequality, poverty, and unemployment prove that not only has the African National Congress (ANC) been unsuccessful in achieving its development goals; but the reality of its macroeconomic policy has not been that of a developmental state. While the presented policy on healthcare in South Africa appears, prima facie, to be committed to deep developmental goals, other policies thwart the intentions of this legislation. These policies entrench and perpetuate inequalities in health outcomes between rural and urban, private, and public, as well as racial profiles of citizens. The policies that undo the developmental spending on healthcare include cadre deployment which ensures weak civil service management and conflicting messages in policy decisions as they develop. Further, this mixed policy approach towards healthcare has undermined South Africa’s development goals. Although the ANC may have to combat the apartheid legacies of inequality, poverty, and unemployment, its failure in achieving meaningful development can be largely attributed to its misdirected policy approach to both its macroeconomic environment and basic healthcare.