Tesla knows average repair costs better than anybody, and while they say the extended warranties are not a "profit center", I am sure they are pricing them so they are not losing money either - in fact I'd imagine they cover some service center overhead. I suspect that Tesla downplaying the extended warranty option is more about trying to keep customers from coming in to the service centers unless they really need something.
So financially, odds are you will come out better without a warranty than with one. (Of course that will be true for some, not true for others, and that's no way to know which camp you are in until it's too late. FWIW it has been true on the 2 Tesla's I've had out of warranty so far, one for 4 years and one for 3 years). However, given that Tesla is not trying to make money on the warranties, the average extra cost is probably not much, plus you get peace of mind having it, plus Tesla gets the money up-front. So if you want a warranty, great, I'd encourage it. But I don't feel it's a likely financial win to have it over not having it, or a "must-have".
The $200 deductible being per visit rather than per item is a nice way to save if you can combine issues; but I suspect it's really another way they encourage you to not visit the service centers more often than you have to.