The doesn't seem all that large for someone with a professional degree, like a M.D. or J.D. America is the land of the free until you get to university.
In contrast, I completed my professional degree and a masters in law at the two best universities in my country for a total out of pocket tuition cost of approximately $9,000. That's around 1.3 orders of magnitude apart.
I'm sure there will be replies about the quality of the alumni networks or the level of scholarship (which would be very poorly founded), but that misses the point: the magnitude of debt is shocking.