Narcissists don’t seek treatment as this would imply they’re imperfect, however destructive their lives are. On the other hand we don’t force treatment on people unless they are an immediate physical threat to someone or themselves. Another aspect, you alluded to, is culture. In the west, especially the US there is a reverence toward these types of behaviour that are in line of the traits seen with overt narcissists. Kind of a positive feedback loop wherein these types filter towards the top of whatever organisation. I believe Musk is narcissistic aswell, and I doubt he is truly autistic. (I think he is self diagnosed, and normally I refrain from gatekeeping, however, I believe he is self aware enough to figure something is different about him and he mistakenly attributed these aberrations in his personality for autism instead of narcissism - I might be wrong though.) Having these two characters in power does not bode well for our civilisation. It makes me nauseous to think that they themselves are unable to recognise the destruction they are bringing onto the world.