The longer the TT, the more lateral forces it will impart to the TV from wind loads and sway forces. The common way to counteract this is by using a TV with a longer wheelbase, but not everybody wants a 350 crew cab long bed. The hitch uses geometry to dampen the effects of the TT on the TV so that you can tow with a shorter wheelbase vehicle.
Some TTs "need" a HA/PP type hitch because they are not inherently well balanced and it's hard to load them so that will tow well. Our previous TT was a Sunnybrook 3310 4-bunk model and the entire area under the bunks was storage, right at the back of the TT. Look where the bunk area is on the floorplan:

This is what the storage looked like:

When we first bought the 2002 Sunnybrook TT we were excited about how much stuff we could pack in there....BBQ, generator, gas grill, etc etc....being relatively new to towing we really didn't stop to think that loading a lot of weight at the very back of the TT would lighten the tongue, and being 34' long didn't help.
Towing it home from the dealer completely brand new and empty, I couldn't get above 45 mph without the trailer starting to sway. Once it was packed it was even worse...the HA enabled us to tow that TT all over the east coast with the kids until we finally sold it in 2007. Towing at 65-70 in all kinds of weather and on all kinds of roads and never worried about sway or control.
Hooking up is different, having the rear camera on the truck helps immensely. I take the TT out in soft sand on the beach and can still get the HA hooked up. Sometimes it takes a little fine tuning of the head angle but I've never had a case where it was impossible.