Think of this for a moment. You are standing in a spot with a 200mm lens on the monopod - in the usual vertical position with the lens roughly horizontal to the ground (front-to-back) and a mouse shows up in front of you, about 10 feet away. How would you point the lens DOWN enough to photograph the mouse if you are using the typical tilt head designed for monopods? You couldn't, of course, unless you made a radical change to the position of the monopod's foot and probably it's length. However with a ball head, the task is extremely simple - merely loosen the knob/lever on the ball head and point the camera down.
While this illustration may be a little silly, it should make the point for using a ballhead on a monopod. The versatility the ball head provides makes the monopod MUCH more useful than just limiting yourself to using it in the "classic" position.
The tilt head on my monopod will tilt forward and backward far enough for my lens to be parallel to the leg. Straight down to the ground or straight up in the sky in a pure vertical position. The same amount of tilt you can get out of a ball head.
That is why I asked the question in the first place. I get the same amount of horizontal tilt as I would with a ball head. I can leave the knob slightly loose and with some pressure I can change the horizontal axis without changing the vertical axis. If I leave the lens ring slightly loose again with a little pressure I can change the vertical axis without changing the horizontal or with a little pressure change both at the same time with out having to lock down the knobs.
Jon made a good point about short glass with out a lens ring. If I mount the camera on the head I have no vertical control other than to tilt the monopod to the left or the right which is impractical.

