The bigger thing DHH doesn't mention or explain is that Basecamp is designed to be intentionally simple. Much of the complexity that you get in client work where you don't control the requirements Basecamp is able to simply avoid by not building.
The idea that if you own your own product and control the requirements that you can have a MUCH cleaner codebase without needing as many tests is 100% true. But, David didn't say that and it's a shame. It's a much more powerful point because there are cases where clean architectures are valuable and the standard Rails MVC pattern isn't enough. At the same time, there are plenty of times where the basics will get you a very long ways. If you control the complexity, simple MVC might be all you ever need.
Everything in software development involves managing requirements and tradeoffs. If you simplify requirements, you reduce complexity. You reduce complexity, you reduce surface area required to test.
It's like weight reduction in cars, you reduce overall weight a few pounds, you can also reduce an extra 5-10 lbs. in required components to support the added weight/complexity.
I just wish that people could discuss these ideas with nuance and empathy towards other project's requirements. Some projects require a lot of tests and have significant inherent complexity, some don't. A one size fits all philosophy might sound appealing, but it doesn't work.
Don't throw the TDD baby out with the bathwater.