Published: Tuesday, 18 Aug 2009 | 6:37 PM ET

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As the debate over health-care reform heats up, fewer Americans say they are in favor of a complete overhaul of the American system, according to a new NBC poll.

Only 21 percent of those surveyed said they believe health care needs a complete overhaul, down from 33 percent in April. An increased number said they’re in favor either a major overhaul (30 percent) or minor reform (31 percent).

Meanwhile, 47 percent said they oppose a public health-care option, up three percentage points since July, while 43 percent favor it, a decrease of three points.

It was the first time that more respondents said they oppose the public health-care option—a government-run program similiar to Medicare—that Republicans argue would drive private insurers out of business.

In recent days, President Barack Obama has backed away from the public option. But at a Medicare conference Tuesday, Health and Human Services Secretary Kathleen Sebelius said the administration remained interested in including it into the overhaul.

President Obama's overall job-approval rating continued to decline, with 51 percent of Americans saying they approve of his performance, down from 53 percent a month earlier. That compares with a 60 percent approval rating in February.

Forty percent said they disapprove of the President’s performance, unchanged from a month prior. It was, however, an increase of 14 percentage points since February.

Forty-one percent said they approve of Obama's handling of health-care reform, unchanged from the month before. Forty-seven percent said they disapprove, up slightly from July. Meanwhile, 62 percent disapprove of the way Republicans in Congress have handled health care reform.

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More Americans said they think Obama’s health care plan would improve their health care — up 3 percentage points at 24 percent. But far more think their health care would worsen—40 percent, an increase of one point.

The survey questioned 805 adults across the country and was conducted between August 15 and 17. The poll has a margin of error of plus or minus 3.5 percentage points.

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