Chop onion and garlic roughly. Pulse plum tomatoes in blender or break about gently in large bowl with hands. Remove all the sausage from casings.
Saute garlic and onions on medium-low heat for 5 minutes to soften.
Add ground sausage to pan and turn heat to medium. Saute sausage for roughly 20 minutes. Break sausage apart with wooden spoon during the saute process.
Add the salt, crushed pepper, oregano, crushed tomatoes, and tomato paste to the sausage and stir it all together. Cover and cook on medium to medium low for 30 minutes.
Boil pasta according to package directions. Before draining pasta reserve 3 cups of pasta water.
Remove lid from sauce at 30 minutes and add 1 cup of pasta water. Stir together and cook for 5 more minutes uncovered.
Turn heat to low and add cream. Stir together well and cook for 2 more minutes. Taste sauce and adjust salt or pepper if necessary.
Place cooked pasta in a large bowl and spoon the sausage sauce all over the pasta. Do not go overboard with the sauce as you might have extra.
Mix the sauce and pasta together and if it is not creamy enough add a 1/2 cup of pasta water to loosen the sauce. Do this in small increments to get the perfect consistency.
Finally add the chopped basil and serve in bowls with Italian bread, grated cheese, and (if any) the extra sauce. Enjoy!