The tax, which would have expired after five years, was designed to pay for equipment and improvements that Munroe officials say would have allowed them to remain competitive in the health care marketplace.
But despite an expensive lobbying effort mounted by Munroe supporters, voters rejected the proposal 58 percent to 42 percent.
The raw percentages tell only part of the story of how badly the tax lost.
Just 12 of the county's 127 precincts supported the tax, almost all of them huddled in a concentrated area of west Ocala between U.S. 441 and Interstate 75. Those same precincts almost all voted for two proposed school taxes during the primary election in August. Both those measures failed as well. (See accompanying maps.)
Precincts 10 (Lillian Bryant Center), 2 (Hampton Center), and 9 (Zion United Methodist Church) all have large populations of minority voters, and all three voted for the tax by comfortable majorities.
In the critical State Road 200 retirement communities, which often decide close elections because of the large number of voting seniors, only the two precincts in the Oak Run retirement community favored the tax, and that by a slim margin. That isn't a surprise, considering that developer Kulbir Ghumman, who founded Oak Run, had been a longtime trustee on the Munroe hospital board.
Opposition to the tax, meanwhile, was particularly strong in The Villages of Marion and in the south Marion County area, which also has a high concentration of retirees.
The three precincts in The Villages defeated the tax by better than a 2-1 margin, a combined 3,337 to 1,507. Nearby precincts in Umatilla and Summerfield opposed it by similarly large margins.
If the geography wasn't disappointing enough for tax proponents, the tax also failed in all three ballot categories: absentee (55 percent against), early voting (57 percent against) and Election Day (59 percent against.)
Here are some other trends that emerged from Tuesday's voting.
Undervotes? What undervotes?
The ballot was long, with a dozen proposed constitutional amendments, so voters could perhaps be forgiven if they gave up toward the end and just left some slots blank.
But most didn't.
The race with the highest profile — president — garnered 161,665 total votes in Marion County.
The constitutional amendments got a range of 145,000 to 154,000 votes per race.
The hospital tax, last on the ballot, got 152,993 total votes.
Early for Obama
President Obama took just 41 percent of the Marion County vote. But he did much better (47 percent) during the eight-day early voting period.
Perhaps this was attributable to the Democratic Party's push for early voting. Other Democrats on the ticket such as school superintendent candidate Diana Greene (46 percent early vote/41 percent overall) and state Senate District 8 candidate Frank Bruno (48 percent early/40 percent overall in Marion) also performed well.
Democratic woes continue
It's no secret that Marion County is dominated by Republican voters, so it also will come as no surprise that Democratic candidates fared poorly here Tuesday.
Only two Democrats won Marion County. Longtime U.S. Sen. Bill Nelson squeaked by Republican Connie Mack with 48.6 percent of the vote to 48 percent for Mack on his way to a landslide victory statewide.
Clovis Watson, Jr. of Gainesville, who won State House District 20, also carried Marion. But Watson was running against a write-in candidate whose name didn't even appear on the ballot.
The rest of the Democratic field got trounced in Marion.
-- Democrat Frank Bruno lost to Republican Dorothy Hukill 60 percent to 40 percent for the state Senate District 8 seat that covers much of Marion County
-- Republican George Tomyn beat Democrat Diana Greene 59 percent to 41 percent in the Superintendent of Schools race
-- Wesley Wilcox beat Democrat Judge Cochran in the Supervisor of Elections race, 59 percent to 41 percent
-- Earl Arnett beat Democrat Jessica Hadley in the County Commission District 5 race
-- Tea party darling Ted Yoho beat Democrat J.R. Gaillot in the race for the 3rd Congressional District, 60 percent to 36 percent (a third candidate got a little over 3 percent of the vote)
-- Republican Rich Nugent beat Democrat David Werder in the 11th Congressional District race by a 2-1 margin
-- Longtime Congresswoman Corrine Brown won re-election but lost in Marion to Republican LeAnne Kolb.
-- and, of course, Mitt Romney beat President Obama here 58 percent to 41 percent
Minority voters flood the polls for Obama
Marion County voters favored Mitt Romney over President Obama 58 percent to 41 percent, which was an even larger majority than they gave Sen. John McCain in 2008 against Obama (55 percent to 45 percent).
But Obama did exceptionally well among minority voters here, winning precincts with large populations of black and Hispanic voters.
-- The four Marion Oaks voting precincts cast 4,334 votes for Obama and just 1,714 for Romney
-- The three precincts in Silver Springs Shores favored Obama 3,549 to 2,022. The Shores is 33 percent black and 16 percent Hispanic, according to the 2010 U.S. Census.
-- The eight precincts in west Ocala, which features a large concentration of black voters, chose Obama by a 3-1 margin, 5,749 to 1,823. Precinct 2, the Hampton Center on West State Road 40, favored Obama by a stunning 46-1 margin, 645 to 14.
Marion likes four amendments
Like the rest of Florida, Marion voters approved three amendments to the Florida Constitution.
Voters favored amendments that give property tax breaks to wounded combat veterans (Amendment 2), the surviving spouses of veterans and first responders (Amendment 9), and low-income seniors (Amendment 11).
But unlike the rest of Florida, Marion voters also favored Amendment 1, dubbed the Health Care Amendment. That measure would have prohibited government from requiring people to buy health insurance or from limiting what insurance they could buy in the free market. It was widely considered a response to the president's health care act, known as Obamacare.
Fifty-three percent of Marion voters supported the Health Care Amendment, while 47 percent opposed it.
Voter turnout: Best and worst
The overall voter turnout was an impressive 72.74 percent, but a few precincts around Marion County far surpassed that figure.
Five precincts topped 90 percent turnout, including three in the On Top of the World senior community on State Road 200.
The On Top of the World Indigo East precinct had a whopping 92.41 percent turnout, followed by Spruce Creek Country Club in Summerfield (92.22), On Top of the World Bay Laurel (92.06), On Top of the World Candler Hills (91.99) and Summerglen, a gated community on Interstate 75 just north of the Marion/Sumter line (90.48).
The worst voter turnout was in Sunny Hill Farms in Umatilla, where just 49.10 percent of voters cast ballots. The Florida Highlands outside Dunnellon had the second lowest turnout at 58.90 percent.