From the lore I've picked up, the Wasteland is far better than the dystopia that was the pre-war world.
I find any sort of world worse than the wasteland pretty hard to imagine, short of one where people can't survive at all. Sure, the government in Fallout may build underground facilities advertised as fallout shelters where horrible experiments often resulting in a greatly shortened lifespan for the inhabitants of these facilities are conducted, but at least there
was a government. In Fallout, the post-war world, the closest thing has killing anyone who doesn't fit their definition of "purity" (which means most people in the wasteland.) among their plans to restore America. For the rest of the population of post apocalyptic America, if your lucky, you might be able to live in Megaton or Rivet City or some other community protected from the outside world. If not, then any day you could wake up to find raiders coming to kill you, super mutants coming to kill you or drag you off, or slavers coming to drag you off.
At least, the pre-war government would probably have a reason to come and drag you off beyond the fact that you were conveniently located, even if that reason is just that you were suspected of being a communist. Before or after the war, though, I think one can agree that the Fallout world would not be a fun place to live.
It would be interesting to get more information on what things were like before the war, though, but what the Fallout world would look like in the hypothetical situation that it had not happen is something we can only guess at.