Preheat oven to 350°F and set the rack to the middle level.
Bring a large pot of salted water to boil and once boiling add the cabbage, turning it every few minutes. Cook until soft (about 10 minutes) then gently place the cabbage into a colander to drain. Once it is cool enough to handle, gently separate 16 leaves. If the leaves are still too hard add the cabbage back to the pot of water for a few more minutes.
Heat a frying pan to medium heat with the butter and onions. Add a pinch of salt and cook the onions until very soft and slightly caramelized (about 12-15 minutes).
Add the onions to a large bowl along with the rice, bulk sausage, ground beef, oregano, pepper, salt, paprika, parsley, and egg. Mix well to combine.
Place a cabbage leaf onto a cutting board and flatten it out. With a paring knife, cut the thick rib out by making a slight v-cut approximately 1 to 2 inches down the leaf. If needed, see the process photos above. Repeat for remaining pieces.
Using a large scoop add 1/3 cup or 65g of filling into the center of the cabbage leaf and fold the cut ends over. Tuck the sides in like a burrito and roll it to close it up. Repeat for the remaining pieces and then place each roll seam side down into a 9x13 baking dish. Note: You might need 2 baking dishes to fit all of the rolls.
Heat the water in a kettle or microwave and then combine with the tomato paste, sugar, and vinegar. Taste test and season with a touch of salt and pepper. Pour the sauce into the baking dish until it mostly covers the rolls. If needed, add more hot water. Cover the dish tightly with foil.
Bake the cabbage rolls until they are super tender. This will take anywhere from 2-3 hours. If during the baking process, the liquid starts to dry out, add another 1/2-1 cup of water.
Once the rolls are tender remove from the oven and let sit for 15 minutes before eating. If the sauce is too thin, remove the rolls to a platter and add the sauce to a pot. Cook the sauce over medium-high heat until it thickens to your liking then remove from the heat and whisk in 3 tablespoons of cold butter, one cube at a time. Pour the thickened sauce over the cabbage rolls. Enjoy!