If you can lose the last few seconds then yes that's fine. But for most applications I've been working on, we didn't have that flexibility (committed means durable).

I don't see any operational complexity with Litestream.io. I think that's an awesome tool. But it's not that different of managing PostgreSQL backups with something like WAL-E.

The complexity of managing your own database server only exists if you don't use a managed service. Then there is no server to maintain and they do all the things you mentioned for you.