So basically an American 1940's but without a justified war, social unrest due to the economic decline and the fact that businesses are cracking down on their employees to prevent foreign spies from using the business as a spring board to invade the country.
A massive reduction in civil liberties and rights in general to the point that martial law is literally the new normal. A Massive surge of the population ripping itself apart either for or against military service, unrestricted research into highly questionable fields with even more questionable ethics. Which lead even further to more unethical projects such as "Vault Tech".
The annexation of Canada and the large amount of unreported war crimes and atrocities committed against all sides involved with the conflict which later escalates into the United States battling the Chinese in Alaska for the Oil pipeline.
Continued price increases that eventually leads to the vast majority of American citizenry to become destitute and impoverish leading to shack towns and riots, which of course leads to additional civilian casualties because police and military forces have to turn on their own population and suppress them.
The new wave of poverty leads to a new plague that quickly sweeps the nation and its neighbors due to the increasingly difficult living situations of the population. Not to mention the astronomical price of basic medical care forcing those who suffer to seek the comfort of illicit substances to mitigate their pain.
Oh and the rich elite basically standing on top of the starving population necks like rats on a sinking ship.
Yeah... I don't think the developers could get away or do the required justice to pull that one off.
However if someone did have the stones to make such a thing it would not be playable in the same way as a Fallout game. The base mechanics simply would not work, due in part because of the way the government is always watching its citizens for signs of treason.
