This paper aims to set out some key alternative macroeconomic policy ideas for further debate and research in the context of the multi-disciplinary approach of the Wits Inequality Project. We ask what kind of macroeconomic policy interventions will be essential for growth and employment generation and to a successful struggle against rising income and wealth inequality in South Africa, and elsewhere. My assertion is that that unless we have a supportive macroeconomic framework, many other economic and social policy interventions for addressing growth and inequality will likely fail to gain much traction or purchase for budgetary and related reasons. I draw on both history and theory to demonstrate the early and respectable roots of heterodox economic thinking and support for a more activist state-led macroeconomic policy. Those supportive of alternative heterodox policy ideas are often and quickly labelled macroeconomic populists or madmen and I aim to show that such heterodox, state led approaches to growth and development also have a rich history and respectable pedigree behind them. I comment briefly on the American New Deal and the recommendations of the South µÚÒ»³Ô¹ÏÍø Macroeconomic Research Group. Both were examples, in very different eras, of progressive macroeconomic policy interventions based on a state-led investment and ‘crowding in’ approach to development in direct contrast to a private finance, market led and ‘crowding out’ neoclassical orthodoxy. The paper then reviews some key ideas underlying a post-Keynesian approach, and ends with some specific proposals for macroeconomic reform in South Africa.