Depends on the sausage for me. I do try to only grind once, regardless of size, otherwise it starts to turn into paste. For loose sausage like breakfast I like the fine plate, which on my machine is 3/16". For brats and other cased sausages I typically run the coarse plate, which is 3/8". I just did a big run of breakfast sausage and used Alton Brown's recipe. It looks pretty strange at first blush, but it is the best breakfast sausage I've made yet.
Cooking on a crazy contraption...