Well they tend to be smaller/medium size companies, because they don't have serious scale yet to hire specialists, but at the same time require reliable HA host

Well they tend to be smaller/medium size companies, because they don't have serious scale yet to hire specialists, but at the same time require reliable HA hosting. It can't just be some databases or web servers setup in a Adhoc fashion. A lot of these articles that compare cloud vs dedicated only compare some web server in data centre. They don't consider building a complete platform is a lot of work. You need to setup databases in highly available preformant fashion, backup solutions, off premise backups, ADC's(Netscalers for example), firewalls, subnets, Storage(SANS), ACLS, Site to site VPNS(or MPLS) etc which requires some knowledgeable people to setup. Companies that setup this for you, rightly charge quite a bit for it.