 As Daniels notices, observing Rawlsian justice may flatten the social gradient in health without eliminating it altogether. For example, the difference principle may permit certain inequalities of income, which are nevertheless possible to eliminate. If income is a causal determinant of health, these permissible income inequalities will (continue to) generate health inequalities if they are left in place. (This scenario is actually only coherent if the relative income hypothesis is the correct account of the causal mechanism. For the explanation, see Sreenivasan 2009b). Daniels holds that the persistence of avoidable health inequalities does not give us reason in justice, independently of the difference principle, to eliminate their underlying cause. In his view, justice permits some avoidable inequalities in health: