Elon just cares about being effective more than anything else and has identified what's required to be effective. Andreessen does a great job explaining that. What's more interesting to me is why, especially if it's as obvious as Andreesen implies. If Elon is able to care about being effective more than anything else, why is it other people can't/don't? If I had to guess, it's related to something I've heard Elon say a lot: "I want to be useful." He pursues this to a pathological and self-destructive degree.
imo The origin of "I want to be useful" is the severe bullying his biographers have covered. Having suffered bullies growing up, if it persists long enough you realize the best defense for being bullied is being useful to as many people as you might need to defend you. It then becomes somewhat of a feedback loop: as you become more useful, the number of people and their desire to destroy you grows, and your best defense is becoming more useful to even more people and so on.