Right, and in a similar situation, if the internal device was given a routable ipv6 address by the ISP's cable modem, you could directly access that device.
This isn't a hypothetical. There are ISPs who do this out of the box. I plugged a linux box into my ISP's cable modem/router in Amsterdam and immediately noticed my ssh port was getting hammered by port scanners. This isn't what most customers, especially those who aren't technically sophisticated, expect.