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They end up limited to knowledgebase and charge a high admin fee for any work and often leave you stranded - you end up hiring support outside.
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They have two different levels of support I believe, one of which is for pay, but it's not exactly a "fully managed" solution. For those who can't manage the server themselves, it's probably wise enough to hire a third party to manage it for them. Obviously though, this means a significant additional cost (especially when compared to the fee for an entry level server).