I think he does care how well stuff works and whether it does what we want--he just takes a very long-term view of that goal.
For example, let's say an ok V1.0 piece of open-source software is released under the BSD license. A startup takes the source, modifies it to create an awesome product, and releases that as a closed-source product.
Everyone loves it and adoption goes through the roof. The company gets hugely successful and is bought by Big Tech Corp Inc....who really just wants the talent. They EOL the great product.
Because it is closed source, the best that customers can do now is to reach back to original mediocre BSD'd code and try to replicate the development that went into the awesome product.
BUT--go back to the beginning. If the mediocre product had been GPL'd, then the startup would have been obligated to release their changes as source code. So even though it was EOL'd by Big Tech Corp, the customer base has the up-to-date source code, and can carry on development and support as a community.
Now, I'm not going to say that is a 100% accurate view of the world...the obvious counter-argument is that aggressive licenses like the GPL3 actually discourage business support of products. Thus a GPL3'd mediocre V1.0 would never have been picked up by the startup in the first place, and never would have been developed into an awesome product.
I won't say I know which argument is correct, but I will say I can at least see where RMS is coming from.