I get that neutral and ground aren't the same thing. That wasn't my point.
Then what was the point? It has to be a neutral, and in this case, it's important. It might be one wire doing the job of both, but you can't use a ground, which could be a bare wire or just metal conduit, for a neutral.
EDIT: nomenclature is everything. A dryer or a range is not 240. They are 120/240. Some dummy might need a dryer circuit, found himself one of them there three prong dryer plugins and cord at a garage sale for cheap to go along with the new used clothes dryer he found at Joe Bobs used furniture emporium and proceeds to run himself a 10/2 "220" line to where the dryer's gonna be. He is going to use the ground for a neutral. It will more than likely be fine, but, what if it's going to a sub panel where the neutral and ground aren't bonded? Then the ground is carrying the neutral current back to the main, where it will finally be introduced to the neutral. It will still probably work fine forever, but there's always the chance something could go wrong.