Some doctors are paid that little in Germany. Here’s an comparative analysis on 2008 data: average net outflows to physicians are higher, but it seems like US physicians may be receiving a substantially larger slice of the budgetary pie https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2010....

That shows MDs making almost twice what you claimed ($130k vs. $70k). Not as high as Americans but that seems insufficient to explain the huge cost differential.