I think it is not true. The barrier between pri and sec is double insulation already. There is no hazardous voltage around such earthed accessible part (SELV only), why 2 MOP is needed?
The problem is really not the hazard voltage at normal condition, but in SFC. The construction of the protection of electrical shock is clear - you need 2 MOP, one for protection under normal condition, and another, for protection at SFC (this is not really explained in 60601, you need to read for example IEC 61140). One way is Basic + protective earthing, if not that you need another way to have to MOP. But your are correct, IF there´s double insulation between primary and secondary (and not only the transformer, of all parts) this means that you will have double from the parts you mentioned.
Parts which are only 1 MOP from mains parts should be earthed with 0.1ohm. Parts which are 2 MOP (or more) don't need to be earthed.
Not really on the first case. Parts with only one MOP can have another MOP (supplementary) forming parts of a double, or being protected by an earthed internal screening. However, the need for two MOP is still there.
I think the main problem is the construction of the insulation system, as created BY THE MANUFACTURER. In Brazil we have a real problem in which manufacturers do not provide insulation diagrams, so it´s really difficult to perform the correct tests without testing wrong insulation (or not testing earthed parts, in this case)
But a biomed should not be trying to re-test 601 in the hospital.
Another historical problem.
One way is to point out IEC 62353 as the way to perform post-market safety testing.