Here is the EXPLAIN after I changed some conf file - now I am running another
EXPLAIN ANALYZE which may take 5 or more hours to complete :,(

effective_cache = 170000
enable_seqscan = on
enable _bitmapscan = on


 QUERY PLAN                                                                     
      
                                                                        
 
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
--------------------------------------------------------------------------------
-
 Limit  (cost=27674.12..27674.21 rows=1 width=8)
   ->  Subquery Scan people_consent  (cost=27674.12..27978.41 rows=3121
width=8)
         ->  Unique  (cost=27674.12..27947.20 rows=3121 width=816)
               ->  Sort  (cost=27674.12..27681.92 rows=3121 width=816)
                     Sort Key: id, firstname, lastname, homephone,
workphone, al
tphone, eligibilityzipcode, address1, address2, city, state, zipcode1,
zipcode2,
 email, dayofbirth, monthofbirth, yearofbirth, ethnic_detail, external_id,
highe
stlevelofeducation_id, ethnicgroup_id, ethnicotherrace, entered_at,
entered_by, 
besttimetoreach_id, language_id, otherlanguage, gender_id,
hispaniclatino_id, ca

nscheduleapt_id, mayweleaveamessage_id, ethnictribe, ethnicasian,
ethnicislander
                     ->  Append  (cost=13595.19..27492.98 rows=3121
width=816)
                           ->  Nested Loop  (cost=13595.19..13602.61 rows=2
widt
h=816)
                                 ->  Unique  (cost=13595.19..13595.20 rows=2
wid
th=8)
                                       ->  Sort  (cost=13595.19..13595.19
rows=2
 width=8)
                                             Sort Key: temp_consent2.id
                                             ->  Unique 
(cost=13595.14..13595.1
6 rows=2 width=16)
                                                   ->  Sort 
(cost=13595.14..135
95.15 rows=2 width=16)
                                                         Sort Key:
temp_consent.
daterecorded, temp_consent.id
                                                         ->  Subquery Scan
temp_
consent  (cost=13595.09..13595.13 rows=2 width=16)
                                                               ->  Unique 
(cost
=13595.09..13595.11 rows=2 width=36)
                                                                     -> 
Sort  (
cost=13595.09..13595.10 rows=2 width=36)
                                                                          
Sort 
Key: id, daterecorded, answer

                                                                          
->  A
ppend  (cost=13506.81..13595.08 rows=2 width=36)
                                                                                
 ->  HashAggregate  (cost=13506.81..13506.83 rows=1 width=36)
                                                                                
       ->  Nested Loop  (cost=58.47..13506.81 rows=1 width=36)
                                                                                
             ->  Nested Loop  (cost=58.47..13503.10 rows=1 width=36)
                                                                                
                   ->  Nested Loop  (cost=58.47..13499.67 rows=1 width=24)
                                                                                
                         ->  Nested Loop  (cost=58.47..13496.64 rows=1
width=24)
                                                                                
                               Join Filter: ("inner".question_answer_id =
"outer
".id)
                                                                                
                               ->  Nested Loop  (cost=58.47..78.41 rows=1
width=
28)
                                                                                
                                     ->  Index Scan using answers_answer_un
on a
nswers a  (cost=0.00..4.01 rows=1 width=28)
                                                                                
                                           Index Cond: ((answer)::text =
'Yes'::
text)
                                                                                
                                     ->  Bitmap Heap Scan on
questions_answers q
a  (cost=58.47..74.30 rows=8 width=16)
                                                                                
                                           Recheck Cond: ((qa.answer_id =
"outer
".id) AND (((qa.question_tag)::text = 'consentTransfer'::text) OR
((qa.question_
tag)::text = 'shareWithEval'::text)))
                                                                                
                                           ->  BitmapAnd  (cost=58.47..58.47
row
s=8 width=0)
                                                                                
                                                 ->  Bitmap Index Scan on
qs_as_
answer_id  (cost=0.00..5.37 rows=677 width=0)
                                                                                
                                                       Index Cond:
(qa.answer_id
 = "outer".id)
                                                                                
                                                 ->  BitmapOr 
(cost=52.85..52.8
5 rows=6530 width=0)
                                                                                
                                                       ->  Bitmap Index Scan
on 
qs_as_qtag  (cost=0.00..26.43 rows=3265 width=0)

                                                                                
                                                             Index Cond:
((quest
ion_tag)::text = 'consentTransfer'::text)
                                                                                
                                                       ->  Bitmap Index Scan
on 
qs_as_qtag  (cost=0.00..26.43 rows=3265 width=0)
                                                                                
                                                             Index Cond:
((quest
ion_tag)::text = 'shareWithEval'::text)
                                                                                
                               ->  Seq Scan on encounters_questions_answers
eqa 
 (cost=0.00..7608.66 rows=464766 width=8)
                                                                                
                         ->  Index Scan using encounters_id on encounters ec 
(c
ost=0.00..3.01 rows=1 width=8)
                                                                                
                               Index Cond: (ec.id = "outer".encounter_id)
                                                                                
                   ->  Index Scan using enrollements_pk on enrollments en 
(cost
=0.00..3.42 rows=1 width=20)
                                                                                
                         Index Cond: ("outer".enrollment_id = en.id)  

             ->  Index Scan using people_pk on people p  (cost=0.00..3.69
rows=1
 width=8)
                                                                                
                   Index Cond: (p.id = "outer".person_id)
                                                                                
 ->  HashAggregate  (cost=88.22..88.24 rows=1 width=36)
                                                                                
       ->  Nested Loop  (cost=58.47..88.22 rows=1 width=36)
                                                                                
             ->  Nested Loop  (cost=58.47..84.51 rows=1 width=36)
                                                                                
                   ->  Nested Loop  (cost=58.47..81.43 rows=1 width=24)
                                                                                
                         ->  Nested Loop  (cost=58.47..78.41 rows=1
width=28)
                                                                                
                               ->  Index Scan using answers_answer_un on
answers
 a  (cost=0.00..4.01 rows=1 width=28)
                                                                                
                                     Index Cond: ((answer)::text =
'Yes'::text)
                                                                                
                               ->  Bitmap Heap Scan on questions_answers qa 
(co
st=58.47..74.30 rows=8 width=16) 
                                     Recheck Cond: ((qa.answer_id =
"outer".id) 
AND (((qa.question_tag)::text = 'consentTransfer'::text) OR
((qa.question_tag)::
text = 'shareWithEval'::text)))
                                                                                
                                     ->  BitmapAnd  (cost=58.47..58.47
rows=8 wi
dth=0)
                                                                                
                                           ->  Bitmap Index Scan on
qs_as_answer
_id  (cost=0.00..5.37 rows=677 width=0)
                                                                                
                                                 Index Cond: (qa.answer_id =
"ou
ter".id)
                                                                                
                                           ->  BitmapOr  (cost=52.85..52.85
rows
=6530 width=0)
                                                                                
                                                 ->  Bitmap Index Scan on
qs_as_
qtag  (cost=0.00..26.43 rows=3265 width=0)
                                                                                
                                                       Index Cond:
((question_ta
g)::text = 'consentTransfer'::text)
                                                                                
                                                 ->  Bitmap Index Scan on
qs_as_

qtag  (cost=0.00..26.43 rows=3265 width=0)
                                                                                
                                                       Index Cond:
((question_ta
g)::text = 'shareWithEval'::text)
                                                                                
                         ->  Index Scan using ctccalls_qs_as_qaid on
ctccalls_qu
estions_answers cqa  (cost=0.00..3.02 rows=1 width=8)
                                                                                
                               Index Cond: (cqa.question_answer_id =
"outer".id)
                                                                                
                   ->  Index Scan using ctccalls_pk on ctccalls c 
(cost=0.00..3
.06 rows=1 width=20)
                                                                                
                         Index Cond: (c.id = "outer".call_id)
                                                                                
             ->  Index Scan using people_pk on people p  (cost=0.00..3.69
rows=1
 width=8)
                                                                                
                   Index Cond: (p.id = "outer".person_id)
                                 ->  Index Scan using people_pk on people 
(cost
=0.00..3.69 rows=1 width=816)
                                       Index Cond: (people.id = "outer".id)
                           ->  Subquery Scan "*SELECT* 2" 
(cost=13595.18..13890
.35 rows=3119 width=677)
                                 ->  Seq Scan on people 
(cost=13595.18..13859.1
6 rows=3119 width=677)
                                       Filter: (NOT (hashed subplan))
                                       SubPlan
                                         ->  Subquery Scan temp_consent2 
(cost=
13595.14..13595.18 rows=2 width=8)
                                               ->  Unique 
(cost=13595.14..13595
.16 rows=2 width=16)
                                                     ->  Sort 
(cost=13595.14..1
3595.15 rows=2 width=16)
                                                           Sort Key:
temp_consen
t.daterecorded, temp_consent.id
                                                           ->  Subquery Scan
tem
p_consent  (cost=13595.09..13595.13 rows=2 width=16)
                                                                 ->  Unique 
(co
st=13595.09..13595.11 rows=2 width=36)
                                                                       -> 
Sort 
 (cost=13595.09..13595.10 rows=2 width=36)
                                                                            
Sor
t Key: id, daterecorded, answer
                                                                            
-> 
 Append  (cost=13506.81..13595.08 rows=2 width=36)

                                                                               
   ->  HashAggregate  (cost=13506.81..13506.83 rows=1 width=36)
                                                                                
         ->  Nested Loop  (cost=58.47..13506.81 rows=1 width=36)
                                                                                
               ->  Nested Loop  (cost=58.47..13503.10 rows=1 width=36)
                                                                                
                     ->  Nested Loop  (cost=58.47..13499.67 rows=1 width=24)
                                                                                
                           ->  Nested Loop  (cost=58.47..13496.64 rows=1
width=2
4)
                                                                                
                                 Join Filter: ("inner".question_answer_id =
"out
er".id)
                                                                                
                                 ->  Nested Loop  (cost=58.47..78.41 rows=1
widt
h=28)
                                                                                
                                       ->  Index Scan using
answers_answer_un on
 answers a  (cost=0.00..4.01 rows=1 width=28)
                                                                                
                                             Index Cond: ((answer)::text =
'Yes'
::text)   
                                                                               
                                       ->  Bitmap Heap Scan on
questions_answers
 qa  (cost=58.47..74.30 rows=8 width=16)
                                                                                
                                             Recheck Cond: ((qa.answer_id =
"out
er".id) AND (((qa.question_tag)::text = 'consentTransfer'::text) OR
((qa.questio
n_tag)::text = 'shareWithEval'::text)))
                                                                                
                                             ->  BitmapAnd 
(cost=58.47..58.47 r
ows=8 width=0)
                                                                                
                                                   ->  Bitmap Index Scan on
qs_a
s_answer_id  (cost=0.00..5.37 rows=677 width=0)
                                                                                
                                                         Index Cond:
(qa.answer_
id = "outer".id)
                                                                                
                                                   ->  BitmapOr 
(cost=52.85..52
.85 rows=6530 width=0)
                                                                                
                                                         ->  Bitmap Index
Scan o
n qs_as_qtag  (cost=0.00..26.43 rows=3265 width=0)
     
                                                               Index Cond:
((que
stion_tag)::text = 'consentTransfer'::text)
                                                                                
                                                         ->  Bitmap Index
Scan o
n qs_as_qtag  (cost=0.00..26.43 rows=3265 width=0)
                                                                                
                                                               Index Cond:
((que
stion_tag)::text = 'shareWithEval'::text)
                                                                                
                                 ->  Seq Scan on
encounters_questions_answers eq
a  (cost=0.00..7608.66 rows=464766 width=8)
                                                                                
                           ->  Index Scan using encounters_id on encounters
ec  
(cost=0.00..3.01 rows=1 width=8)
                                                                                
                                 Index Cond: (ec.id = "outer".encounter_id)
                                                                                
                     ->  Index Scan using enrollements_pk on enrollments en 
(co
st=0.00..3.42 rows=1 width=20)
                                                                                
                           Index Cond: ("outer".enrollment_id = en.id)
                                                                                
               ->  Index Scan using people_pk on people p  (cost=0.00..3.69
rows

=1 width=8)
                                                                                
                     Index Cond: (p.id = "outer".person_id)
                                                                                
   ->  HashAggregate  (cost=88.22..88.24 rows=1 width=36)
                                                                                
         ->  Nested Loop  (cost=58.47..88.22 rows=1 width=36)
                                                                                
               ->  Nested Loop  (cost=58.47..84.51 rows=1 width=36)
                                                                                
                     ->  Nested Loop  (cost=58.47..81.43 rows=1 width=24)
                                                                                
                           ->  Nested Loop  (cost=58.47..78.41 rows=1
width=28)
                                                                                
                                 ->  Index Scan using answers_answer_un on
answe
rs a  (cost=0.00..4.01 rows=1 width=28)
                                                                                
                                       Index Cond: ((answer)::text =
'Yes'::text
)
                                                                                
                                 ->  Bitmap Heap Scan on questions_answers
qa  (
cost=58.47..74.30 rows=8 width=16)
                 
                                       Recheck Cond: ((qa.answer_id =
"outer".id
) AND (((qa.question_tag)::text = 'consentTransfer'::text) OR
((qa.question_tag)
::text = 'shareWithEval'::text)))
                                                                                
                                       ->  BitmapAnd  (cost=58.47..58.47
rows=8 
width=0)
                                                                                
                                             ->  Bitmap Index Scan on
qs_as_answ
er_id  (cost=0.00..5.37 rows=677 width=0)
                                                                                
                                                   Index Cond: (qa.answer_id
= "
outer".id)
                                                                                
                                             ->  BitmapOr 
(cost=52.85..52.85 ro
ws=6530 width=0)
                                                                                
                                                   ->  Bitmap Index Scan on
qs_a
s_qtag  (cost=0.00..26.43 rows=3265 width=0)
                                                                                
                                                         Index Cond:
((question_
tag)::text = 'consentTransfer'::text)
                                                                                
                                                   ->  Bitmap Index Scan on
qs_a

                                                   ->  Bitmap Index Scan on
qs_a
s_qtag  (cost=0.00..26.43 rows=3265 width=0)
                                                                                
                                                         Index Cond:
((question_
tag)::text = 'shareWithEval'::text)
                                                                                
                           ->  Index Scan using ctccalls_qs_as_qaid on
ctccalls_
questions_answers cqa  (cost=0.00..3.02 rows=1 width=8)
                                                                                
                                 Index Cond: (cqa.question_answer_id =
"outer".i
d)
                                                                                
                     ->  Index Scan using ctccalls_pk on ctccalls c 
(cost=0.00.
.3.06 rows=1 width=20)
                                                                                
                           Index Cond: (c.id = "outer".call_id)
                                                                                
               ->  Index Scan using people_pk on people p  (cost=0.00..3.69
rows
=1 width=8)
                                                                                
                     Index Cond: (p.id = "outer".person_id)
(131 rows)




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