What matters is what you watch
I am not sure that Locals are ALWAYS what matters to people. I think it's a combination, and I think you have to "Shop" around in order to get what you want in HD. For me, the combination of Dish and OTA gets about 85% of my normal viewing in HD.
That would be:
Local CBS through Dish (can't get a decent signal from Channel 2 in Chicago 50 miles away)
NBC, ABC, WGN, PBS (two of them), FOX and WCIU (Channel 26 for local sports) in HD over the air (I generally don't use Dish for the networks other than CBS because OTA quality is better) and PBS and other locals are not available.
Local RSN through Dish (Comcast Sports Net Chicago)
ESPN, Big Ten Network (not on cable in this area, by the way), TBS, TNT for Sports.
History, A&E, Discovery Networks as the most popular Cable channels.
For movies, we have bought HD PPV, and we do watch HBO, etc., in HD. And it would be nice to have more, but ...
So, between Dish and OTA, that would cover about 85% of what we watch, in HD.
The main exception right now would be Speed. I am NOT a NASCAR guy, so the stuff I would watch on Speed (F1, MotoGP, SCCA) is not likely to be in HD for a while, anyway.
So my advice is to figure out what's important to you, and go find it.
For me, that is Dish and OTA
Comcast, the cable competitor, comes up short. OTA by itself won't cut it. And Directv only met this requirement recently and their DVR sucks eggs. We don't get U-Verse.