I remember actually understanding sendmail.cf syntax. Those were the days!
The problem is not the daemons; those are easy.
The problem is spam on the inbound and deliverability on the outbound. And I do /not/ want to fight that fight on my own!
I've personally not found this difficult. Unless perhaps you're dealing very large volumes of mail and overhead of SpamAssassin is an issue. Mail volume in 10s of thousands/day on a low end VPS has been no problem for me.