Any progress on high availability deployments yet? Or does it still rely on problematic, 3rd party tools?

Last time I was responsible for setting up a HA Postgres cluster it was a garbage fire, but that was nearly 10 years ago now. I ask every so often to see if it has improved and each time, so far, the answer has been no.

You should definitely give pg_auto_failover https://github.com/citusdata/pg_auto_failover/ a try. I've written about my experience here: https://github.com/citusdata/pg_auto_failover/discussions/61... which hasn't changed since..