Managed databases are quite good. RDS is very mature and does a very good job with fail over, backups and is very easy to setup.
I don't want to manage anything that needs to be clustered. Technologies like that often need trained engineers with good knowledge of how the product behaves if we want to manage it ourselves.
Alas it's the only way to get decent efficiency on certain cloud platforms. However, you often can't get the custom plugin and modules. On amazon bare metal ephemeral disk instances are decent high performance alternatives but you can't beat aurora for most pg usecases.
