Down home as far as a grinder goes it depends on how much and what kind of grind you want, IMO. I didn't get along well with the Kitchen Aid simply because of its size. I use a hand cranked grinder that I got from The Sausage Maker many years ago. It has 3 plates which allows you to grind accordingly.
The best tasting grind comes from the chuck, or shoulder area and the best way to grind it is to trim all the fat off and grind it separately straight from a time in the freezer. Doing this you can adjust the fat content, after using a coarse grind give it a good hand mix and then do the final grind and you get a balanced mix.
You don't get E-coli or mad cow from home ground meat as long as it's cleaned before grinding. You also rarely hear about getting it from a meat market grind. It comes from processors who do nothing but the chubs and use down and out cattle unfit to be butchered into cuts. If you avoid the 3# and 5# chubs or if you have to buy them make sure to cook them tasteless.