They don't really think that way.
See Trump defunding medical research. Capitalists need medical care too, but they think quarterly.
You're right about the defunding of research - it's loudly proclaimed as a way to save money.
You're also right that the long term effects would indeed cost a lot more but I would add only if the current social contract is kept in place. As I see it, the chainsaw brandishing is really aimed at the latter, the former is just for show.
Redefining the social contract appears to be the endgame here, in that case, the thinking goes much further than quarterly.
So quality of care will decrease (to a much lesser extent) for rich people as well.
Do you think they accounted for that? I doubt it.
If you watch the video of Dan Bongino talking about power you'll get the vibes.