A bit hand wavy. It obviously depends on the business and what "least of concerns" entails. In most cases businesses justify the cost of managed databases for

A bit hand wavy. It obviously depends on the business and what "least of concerns" entails. In most cases businesses justify the cost of managed databases for less risk of downtime. A HA postgres server on crunchy can cost over $500/mo for a measly 4vCPU. I would agree that it's the least of concerns but for a different reason. Spending all your time optimizing for optimal performance (assuming sensible indexing for what you have) by continuously redesigning your DB structure when you don't even know what your company will be doing next year isn't worth the time for a few hundred a month you might save.