This paper reports on a conversation about design for health equity in Latin America, expanding on case studies from "The Little Book of Design for Health in Latin America." The discussion explored barriers to and opportunities for implementing design approaches in healthcare across the region. Key barriers include tension between medical science and lived experiences, funding constraints, and the need for culturally sensitive approaches to health equity. Opportunities highlighted include adopting holistic human-centered approaches, leveraging community knowledge, and shifting focus to prevention. The conversation emphasised the potential for design to bridge gaps between medical expertise, policymaker goals, and community needs. It also highlights the importance of decolonising research approaches and developing ethical frameworks for health design. The paper concludes by reflecting on the nuanced understanding of challenges and opportunities revealed, and the potential for design to drive innovation in building more equitable health systems in Latin America.