For me, the biggest difference is you tow a fifth wheel, but you can tow stuff with a motor home. If you just need a go-about vehicle you can tow a toad, or drop the trailer and use the truck, but if you need to tow a trailer with a couple of race cars in it tough to do with a fifth wheel. I couldn't have a fifth wheel due to that kind of limitation, but I see a lot of people who just love the fifthwheel and never have a need to tow a boat, or a travel trailer behind the MH, or stuff like that.
So bottom line, it boils down to what do you need to do and how can you best solve that problem? Everyone is different.
Brian