Since my itineraries are many and varied I actually adopt both approaches. In some cases, if the price is right I'll book using points and even buy points (case in point my recent acquisition of 160,000 Aeroplan points for $2,800 CAD to book SYD > MEL > AUH > ZRH > LIS > YYZ, LAX > TPE > ICN > SYD all in J). However, at least for Australian domestic travel, I don't really see the use in using points to book a domestic flight. Often the red e-Deals and the occasional JetStar ticket are much better value than spending tens of thousands of points on a similar booking. In which case I can earn QFF status that way. Indeed, most of my status has been earned from domestic travel and the occasional long haul "domestic" trips to AKL and HNL. A lot of it really comes down to how much does it cost to acquire the status and what benefits you'll get (more on that later)
Another key factor is who is paying for travel. If I have to travel to a conference and my employer is paying, then I don't have much latitude in booking aside from maybe the carrier and the schedule (and yes I'll be seated in economy). In which case I can be strategic there and book with SkyTeam if I need to maintain Delta status or OneWorld for Qantas status.
In those instances where I must travel in economy, having status does make a difference. Sitting in an emergency exit row over-wing exit on a United 777 with 50+ inches of pitch makes a huge difference flying back to Los Angeles than being stuck in a middle seat at the back of the bus. In terms of lounges, yes AmEx Platinum and Priority Pass do offer some options but depending on the airline in question it may not actually be an option. To give you a perfect example, I'm flying JetStar this week from Sydney to Perth. Yes, the AmEx Platinum will get me into the nice REX Lounge at terminal 2 but on my way back from Perth there aren't any such lounges available. In which case I can use the Qantas Club as a Qantas Gold travelling on JetStar.
One other point that needs to be raised is that holding status can enhance your experience travelling in business or first. As someone who has moved continents several times now, having that United Premier Gold has been a god send. It has enabled me to check in 3 suitcases instead of the 2 I would get in business or 1 I would get in economy. Status also makes a difference, especially during IRROPs. I can't tell you the number of times I have flown with and without status in business class and encountered an IRROPs and notice the difference in how I'm treated. Almost always, when I had status the rebooking engine would take note and before I needed to raise a finger would rebook me on the absolute next available flight. Meanwhile when I didn't have status it involved having to fight with customer service to get things sorted.
In terms of status, I try and aim for the sweet spot: mid-tier status on the major alliances. This enables me to get treated well irrespective of which airline I ultimately end up booking. Often said status can be acquired quite inexpensively indeed through status matches. For instance, I flew YYZ to GLA last month on a $1,900 CAD KL J fare and was able to match to Delta Gold medallion on that trip alone through January 2024. I may never have access to the Qantas First class lounges as those Qantas devotees who earned World Platinum status by ensuring they only took QF and OW flights, but I have options. I can choose whichever airline offers the best price and routing knowing full well I'll have lounge access, priority services and baggage allowance.
-RooFlyer88