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To make the sauce: In a large skillet, melt butter over medium heat. Add onion and cook for a few minutes, stirring occasionally, until soft and translucent. Add garlic and cook until fragrant, about 1-2 minutes.
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Add wine or balsamic vinegar and cook for a couple of minutes until liquid has evaporated. Add crushed tomatoes, sugar, oregano, and red pepper flakes, and season with salt and pepper. Bring just to a boil, then reduce heat to low and let simmer until sauce has thickened, 20-30 minutes.
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Meanwhile make the pasta: In a large pot, bring 2-2.5 quarts/liters of water to a boil. Add ½ tablespoon salt, followed by the pasta. Cook until al dente (i.e., slightly firm to the bite, not crunchy nor soft). Drain well and set aside.
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Once sauce has thickened, stir in cream and Parmesan. Season with salt and pepper to taste. Stir in pasta and cook on very low heat, tossing to combine for 1 minute until warm.
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Serve immediately. Garnish with basil or parsley and Parmesan, if desired.