As he points out in his Joe Rogan interview from yesterday, highly-skilled specialists like neurosurgeons often don't do all that well, as their income is pegged to their time spent working, and their lifestyle costs often scale linearly with their income.
Of course that changes if you can break out of being an hourly-billing practitioner, and become an entrepreneur, like the dentist I know who built a successful chain of clinics then sold it to a large heath service provider.
You're doing a lot of picking holes in his points (much of critique seems to come down to luck being more important than anything else). But consider that this is always going to be easy to do for something like this that is specifically designed to be a set of simple, broadly-applicable rules of thumb.
Of course there will be limitless numbers of exceptions or domain-specific variations. The world is infinitely complex.
But there are still patterns than can be observed and principles that can be applied that will give people a better chance of a successful outcome than had they not applied those principles, and that's what he's seeking to share here.
And he deserves to be listened to, given that he's said he started learning/refining/applying these principles from a young age, and credits them for his own achievements, which are formidable and far from accidental (see the story of how he sued two of the biggest VC firms in Silicon Valley after they tried to screw him out of what he was due for his stake in the first company he helped build).
As for luck: nobody, least-of-all Naval, claims that it is immaterial to many people's success or opportunities.
But it's also uncontrollable, so you may as well forget about it, and focus on what you can control: making decisions that increase the probability of getting the outcome you want.