Not only that, you have to figure out how to fix the thing if the HA contraption breaks. There's also security to think about (do you run a CA? how do you hand

Not only that, you have to figure out how to fix the thing if the HA contraption breaks. There's also security to think about (do you run a CA? how do you handle Postgres certificates, etcd certificates, rotation, revocation, etc). Some hosted providers also have nice value-adds like query-level performance monitoring and DBA services